Simultaneous comparison of the predictive values of two binary diagnostic tests in the presence of categorical covariates.

Abstract

Comparison of predictive values of diagnostic tests is a topic of interest in Medical Statistics, and has been the subject of different studies. In clinical practice, it is frequent to observe categorical covariates when comparing diagnostic tests. In this framework, a global hypothesis test is proposed to simultaneously compare the predictive values of two diagnostic tests when in all of the individuals categorical covariates are observed. This hypothesis test is solved through regression models and also by weighted least squares method for the analysis of categorical data. Simulation experiments were carried out to study the asymptotic behavior of these methods when a binary covariate is observed and when a covariate with three categories is observed, and these were compared to the behavior of the global test when the covariate is ignored. In general, the method based on regression models has shown to have better asymptotic behavior than the other methods. Furthermore, we studied the application of the method based on the regression models when no covariate is observed, for which the individuals in the sample are randomly assigned to a binary dummy random variable. Simulation experiments carried out showed that this method has greater power than the method without the covariate. The results were applied to two examples.