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Abstract

Title: Bootstrap estimation of diagnostic accuracy with patient-clustered data.
Author: Rutter CM
Journal: Acad Radiol 7(6):413-419
Year: 2000

Abstract: RATIONALE AND OBJECTIVES: The purpose of this study was to describe a simple bootstrap approach for estimating sensitivity, specificity, and the area under the receiver operating characteristic curve for multisite test outcome data. MATERIALS AND METHODS: The performance of bootstrap estimates was evaluated and compared with that of analytic estimates by using a simulation study. Bootstrapping was demonstrated by using data from a previous study comparing two angiographic methods. RESULTS: Analytic and bootstrap estimates had similar coverage rates for 95% confidence intervals. With many sites per patient, bootstrap estimates had slightly better coverage than analytic estimates. Bootstrap percentile intervals had better coverage than asymptotic normal bootstrap intervals. CONCLUSION: Bootstrapping is a useful method of estimating confidence intervals for the area under the receiver operating characteristic curve, sensitivity, and specificity when data are correlated.