诊断试验联合应用与贝叶斯定理在结果解释中的应用

Using of combined diagnostic tests and applying Bayes formula to explain results

目前,对检验方法的分析性能评价研究较为深入,评估方案已渐成熟,但检验方法的临床性能评价工作尚未得到广泛应用。临床工作中,常因临床诊疗需要联合应用多项诊断试验,对此,如何应用才能取得诊断试验理想的敏感度和特异度,降低成本,以及合理科学地解释诊断试验的结果,这是困扰临床实验室人员和医生的问题。本文仅介绍诊断试验联合应用的方式及如何运用贝叶斯定理对联合试验结果进行解释,并分析诊断试验不同联合方式对诊断试验的敏感度、特异度及成本所产生的影响,以期提高实验室人员对联合诊断试验结果的解释水平和临床试验诊断能力。

At present, analytic performance evaluation of laboratory test and its evaluation methods have grown to maturity, but the clinical performance evaluation of diagnostic test is still not widely applied. In the process of clinical diagnosis and treatment, multiple diagnostic tests are combined to assess the remain to be disease status. However, how to combine the diagnostic tests, decrease the cost, and explain diagnostic test results for achieving satisfied sensitivity and specificity remain to be a puzzling problem for clinical laboratorian and doctor. In this paper, we introduced the method to combine diagnostic tests in a different way, revealed how to explain results with Bayes formula, and analyzed the effect of different diagnostic test combined ways on specificity, and cost improvement. In a word, we aim to improve the ability of explaining combined tests results and clinical diagnostic tests application for laboratorians.