Abstract
Thorough evaluation of a screening test requires conducting a series of studies to ascertain its ability to detect accurately disease, as well as its benefits and costs. In this article, I review the steps involved in evaluating a screening test, using the case of prostate-specific antigen (PSA) screening for prostate cancer as a case study. I discuss designs for quantifying the diagnostic properties of a screening test and compare several different studies that have produced quite different estimates of the diagnostic accuracy of PSA screening. I also review methods that may be used to combine other markers or tests with PSA to improve test accuracy. Determining the benefits of a screening test is complex, particularly when information from randomized trials is lacking. I review several observational studies of PSA benefit and discuss the use of computer models for inferring the impact of screening from trends in population mortality.
Original language | English (US) |
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Pages (from-to) | 308-315 |
Number of pages | 8 |
Journal | Urologic Oncology: Seminars and Original Investigations |
Volume | 26 |
Issue number | 3 |
DOIs | |
State | Published - May 2008 |
Externally published | Yes |
Keywords
- Case-control study
- Mass screening
- Prostate-specific antigen
- ROC curve
- Sensitivity
- Specificity
- Verification bias
ASJC Scopus subject areas
- Oncology
- Urology