Table 3 Accuracy Measure (Sensitivity, Specificity, PPV and NPV) Estimates, with 95% Confidence Intervals, Adjusted for Verification Bias
Statistical Methods for Verification Bias Adjustment | ||||||
|---|---|---|---|---|---|---|
Complete Case Analysis (Unadjusted Approach) (N = 166) | Begg and Greenes using Three Screening Tests (N = 403) | Multiple Imputation using Three Screening Tests (using standard logistic regression) (N = 403) | Multiple Imputation using Three Screening Tests, using penalised logistic regression (Firth’s method) (N = 403) | |||
Prevalence of clinically significant prostate cancer | 9.6% (5.6 to 15.2%) | 4.5% (2.6 to 6.8%) | 4.7% (3.0 to 7.3%) | 4.0% (2.5 to 6.4%) | ||
Screening Tests | MRI | Prevalence of positive MRI | 53.0% (45.4 to 60.5%) | 24.1% (20.1 to 28.5%) | 24.1% (20.1 to 28.5%) | 24.1% (20.1 to 28.5%) |
Accuracy measures | Sens = 87.5% (61.7 to 98.4%) Spec = 50.7% (42.4 to 58.9%) PPV = 15.9% (9.0 to 25.2%) NPV = 97.4% (91.0 to 99.7%) | Sens = 87.9% (68.8 to 100.0%) Spec = 78.9% (74.8 to 82.9%) PPV = 16.4% (9.8 to 24.8%) NPV = 99.3% (98.0 to 100.0%) | Sens = 82.2% (58.9 to 88.0%) Spec = 78.8% (74.4 to 82.6%) PPV = 16.0% (10.0 to 24.9%) NPV = 98.9% (97.0 to 99.6%) | Sens = 87.5% (64.0 to 96.5%) Spec = 78.6% (74.2 to 82.4%) PPV = 14.4% (8.8 to 22.8%) NPV = 99.3% (97.6 to 99.8%) | ||
US | Prevalence of positive ultrasound | 51.2% (43.6 to 58.8%) | 23.6% (19.7 to 28.0%) | 23.6% (19.7 to 28.0%) | 23.6% (19.7 to 28.0%) | |
Accuracy measures | Sens = 56.3% (29.9 to 80.2%) Spec = 49.3% (41.1 to 57.6%) PPV = 10.6% (5.0 to 19.2%) NPV = 91.4% (83.0 to 96.5%) | Sens = 56.3% (31.7 to 78.3%) Spec = 78.0% (73.8 to 81.6%) PPV = 10.7% (5.2 to 18.1%) NPV = 97.4% (95.3 to 99.0%) | Sens = 53.7% (31.6 to 74.3%) Spec = 77.9% (73.5 to 81.7%) PPV = 10.6% (5.9 to 18.7%) NPV = 97.2% (94.7 to 98.5%) | Sens = 56.3% (33.2 to 76.9%) Spec = 77.8% (73.4 to 81.6%) PPV = 9.5% (5.1 to 17.0%) NPV = 97.7% (95.4 to 98.9%) | ||
PSA | Prevalence of positive PSA | 21.1% (15.5 to 28.0%) | 9.7% (7.1 to 13.0%) | 9.7% (7.1 to 13.0%) | 9.7% (7.1 to 13.0%) | |
Accuracy measures | Sens = 37.5% (15.2 to 64.6%) Spec = 80.7% (73.4 to 86.7%) PPV = 17.1% (6.6 to 33.6%) NPV = 92.4% (86.4 to 96.3%) | Sens = 36.4% (14.2 to 63.8%) Spec = 91.6% (88.5 to 94.0%) PPV = 16.9% (5.4 to 29.3%) NPV = 96.8% (94.5 to 98.4%) | Sens = 35.6% (17.1 to 58.0%) Spec = 91.5% (88.4 to 93.9%) PPV = 16.6% (8.1 to 31.4%) NPV = 96.6% (94.2 to 98.0%) | Sens = 37.5% (18.5 to 61.4%) Spec = 91.5% (88.3 to 93.9%) PPV = 15.4% (7.2 to 29.7%) NPV = 97.3% (95.0 to 98.5%) | ||