32: Evaluation of Rater Performance for Ordinal Diagnostic Tests Using Latent Class Models

Thomas M. Menino Convention & Exhibition Center 

Many ordinal discrete diagnostic tests, such as breast cancer tumor grade, are prognostic factors but are often subjective and lack reproducibility. With multiple independent ratings, it is important to evaluate and compare performance among raters.. Here first we consider testing whether one of the raters can act as the gold standard, with the alternative that the gold standard is latent and the observed ratings are modeled by a latent class model (Kruskal, 1977; Dawid & Skene, 1979). When indeed none of the raters can act as the gold standard, we consider both the maximum likelihood method and the Bayesian method for estimating and comparing the concordance between each rater and the latent gold standard. Both simulation studies and application to tumor grade and molecular subtypes of breast cancer are used to illustrate these methods.

Discrete diagnostic tests

Latent class models 

ENAR