Degradation of screening test sensitivity from a retrospective to a prospective study

Abstract Number:

3510 

Submission Type:

Contributed Abstract 

Contributed Abstract Type:

Poster 

Participants:

Yibai Zhao (1), Roman Gulati (2), Antonio Olivas-Martinez (3), Jane Lange (4), Ruth Etzioni (5)

Institutions:

(1) Fred Hutchinson Cancer Center, N/A, (2) Fred Hutch Cancer Center, N/A, (3) University of Washington, N/A, (4) Oregon Health and Science University, Portland, OR, (5) Fred Hutchinson Cancer Research Center, N/A

Co-Author(s):

Roman Gulati  
Fred Hutch Cancer Center
Antonio Olivas-Martinez  
University of Washington
Jane Lange  
Oregon Health and Science University
Ruth Etzioni  
Fred Hutchinson Cancer Research Center

First Author:

Yibai Zhao  
Fred Hutchinson Cancer Center

Presenting Author:

Yibai Zhao  
Fred Hutchinson Cancer Center

Abstract Text:

The probability that a screening test yields a positive result when preclinical disease is present is a key driver of its potential benefit. However, when this test sensitivity is estimated in a retrospective study, results tend to be more favorable than what can be expected in a prospective study. To investigate degradation of test sensitivity in a prospective setting, we propose an analytic model in which the test sensitivity increases with the time spent in a preclinical state. The model is further developed to include stage-specific sensitivity variations. We also examine effects of imperfect receipt and sensitivity of second-line confirmation tests and implications of the test for finding clinically insignificant disease. Over a range of settings, we find test sensitivity is markedly degraded in a prospective study, particularly when the disease has longer mean sojourn times, receipt or sensitivity of confirmation test is lower, or the screening test is given at an earlier age. Additionally, the sensitivity of the test to detect clinically significant disease in proportion to the fraction of preclinical disease that is clinically insignificant.

Keywords:

Test sensitivity|Stage-specific sensitivity|Retrospective study|Prospective study| |

Sponsors:

Section on Medical Devices and Diagnostics

Tracks:

Diagnostics

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