Estimation of the Youden Index and its Associated Cutoff Point

Fluss, Ronen; Faraggi, David; Reiser, Benjamin

doi:10.1002/bimj.200410135

Cited by 1,956 publications

(1,537 citation statements)

References 21 publications

(26 reference statements)

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“…The PLI and SIQR correlated at r ϭ 0.62, with Cronbach's ␣ ϭ 0.95 and 0.89, respectively. These 2 continuous predictors were entered simultaneously into a logistic regression model (evaluated by Wald's statistic) to produce the receiver operating curve (ROC) to determine the optimal threshold for sensitivity and specificity with respect to the 1990 ACR criteria, using the Youden index (sensitivity ϩ specificity Ϫ 1) (17). The Hosmer-Lemeshow test was used to evaluate goodness of (20).…”

Section: Significance and Innovationsmentioning

confidence: 99%

Criteria for the Diagnosis of Fibromyalgia: Validation of the Modified 2010 Preliminary American College of Rheumatology Criteria and the Development of Alternative Criteria

Bennett

Friend

Marcus³

et al. 2014

Arthritis Care & Research

108

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Objective. To validate the 2011 modification of the 2010 American College of Rheumatology (ACR) preliminary criteria for the diagnosis of fibromyalgia (2011ModCr) and develop alternative criteria in a sample of patients with diverse pain disorders that are commonly seen in everyday practice by pain specialists, rheumatologists, and psychologists. Methods. Eight clinicians from geographically varied locations in the US evaluated patients with chronic pain and psychiatric disorders using a standard set of questions that included the 2011ModCr questions, the Symptom Impact Questionnaire (SIQR), a 28-area pain location inventory (PLI), and the Short Form 36. Alternative diagnostic criteria were developed from the same data set using logistic regression and receiver operating curve analysis. Results. Complete data on 321 patients were evaluated; there were 135 patients with fibromyalgia (according to the 1990 ACR criteria) and 186 patients with 16 other common chronic pain problems. Comparing the 2011ModCr with the 1990 ACR criteria provided a sensitivity of 83%, a specificity of 67%, and a correct classification of 74%. Alternative criteria were derived from the 10-item symptom score from the SIQR symptoms and the 28-area PLI. Maximal diagnostic accuracy was obtained with >17 pain sites (range 0 -28) and an SIQR symptom score of >21 (range 0 -50). These alternative criteria had a diagnostic sensitivity of 81%, a specificity of 80%, and a correct classification of 80%. Conclusion. The 2011ModCr had robust operating characteristics. Alternative criteria based on symptom items from the SIQR and pain locations from the PLI had comparable operating characteristics, with somewhat better specificity and ease of use.

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Section: Significance and Innovationsmentioning

confidence: 99%

Criteria for the Diagnosis of Fibromyalgia: Validation of the Modified 2010 Preliminary American College of Rheumatology Criteria and the Development of Alternative Criteria

Bennett

Friend

Marcus³

et al. 2014

Arthritis Care & Research

108

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“…The Youden index was higher when we used the cut-off of ≤11 instead of 10 (0.285 versus 0.265). The Youden index is a frequently used summary measure of the ROC curve, measuring the effectiveness of a diagnostic marker and enabling the selection of an optimal threshold value for the marker 8 . The index ranges from -1 to +1.…”

Section: Discussionmentioning

confidence: 99%

Validity of the International HIV Dementia Scale in Brazil

Rodrigues

Oliveira

Grinsztejn

et al. 2013

Arq. Neuro-Psiquiatr.

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The International HIV Dementia Scale (IHDS) is a crosscultural screening test to detect HIV dementia. It is quick and does not require a neurologist to administer it. It was initially tested on HIV patients from the USA and Uganda, with reported sensitivity and specificity of 80 and 55%, respectively 1 . Subsequently, it was translated into different languages and validated in distinct settings 2,3 . We aimed to validate the IHDS in a Brazilian cohort of HIV patients and determine if non-clinician health professionals can reliably administer the IHDS. METHODSWe randomly selected 187 of 2,678 HIV patients to undergo a full neurological and neuropsychological assessment. The required number of patients was determined with the statistical program R. Exclusion criteria were age <18 years, current or past opportunistic central nervous system disease, current or past history of drug use or alcohol abuse and severe medical, psychiatric or neurologic disorder believed to ABSTRACT HIV-associated neurocognitive disorders (HAND) remain prevalent in highly active antiretroviral therapy (HAART) era. Tests to detect HAND are needed for early diagnosis and treatment. Validity of International HIV Dementia Scale (IHDS) has been determined in different countries. The aims of this study were validate IHDS in a Brazilian cohort of HIV-patients and verify if IHDS can be reliably administered by a nonclinician health professional. One hundred and eighty-seven (187) patients were submitted to a full neuropsychological assessment. IHDS was administered twice to each patient (by a non-clinician and by a neurologist). HAND was diagnosed in 98 individuals (68 on HAART). IHDS had sensitivity of 55% and specificity of 80%. IHDS had fair agreement with neuropsychological tests (k 0.355) and moderate-to-strong agreement between different evaluators (interclass correlation coefficient (ICC) 0.684). HAND is prevalent nowadays. IHDS is quick and easy to administer, but has marginal sensitivity for the detection of HIV cognitive impairment other than dementia.Key words: Acquired Immunodeficiency Syndrome, HIV, dementia. RESUMO Distúrbios neurocognitivos associados ao HIV (HAND) ainda são comuns em pacientes usando terapia antirretroviral de alta eficácia (HAART).Testes diagnósticos para detecção de HAND são necessários para diagnóstico e terapia precoces. Nossos objetivos foram validar em uma população brasileira a escala internacional de demência pelo HIV (IHDS), já utilizada em outros países, e avaliar se pode ser confiavelmente aplicada por um profissional não médico. Avaliamos 187 pacientes com uma extensa bateria neuropsicológica. IHDS foi ministrada duas vezes (por médico e não médico). HAND foi diagnosticada em 98 indivíduos (68 em uso de HAART). A IHDS teve sensibilidade de 55% e especificidade de 80%, com pouca concordância com os testes neuropsicológicos (k 0,355) e moderada a forte concordância entre observadores (coeficiente de correlação interclasse (ICC) 0,684). HAND ainda é prevalente nos dias atuais. IHDS é um instrumento rápido ...

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“…We considered a decline in FVC of >0.08 L/year on the ROC curve to be the optimal cut-off point by the Youden Index method (26) and then determined the optimal cut-off predictive score to be 0.398290 with the following formula: The sensitivity, specificity, positive predictive value, and negative predictive value of this cut-off value were 75.0%, 85.7%, 75.0%, and 85.7%, respectively.…”

Section: Predictive Scorementioning

confidence: 99%