HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

Electronic Letters to:

Evidence-based Laboratory Medicine and Test Utilization: Thomas Keller, Hermann Butz, Michael Lein, Maciej Kwiatkowski, Axel Semjonow, Hans-Joachim Luboldt, Peter Hammerer, Carsten Stephan, and Klaus Jung Discordance Analysis Characteristics as a New Method to Compare the Diagnostic Accuracy of Tests: Example of Complexed Versus Total Prostate-Specific Antigen Clin Chem 2005; 51: 532-539 [Abstract] [Full text] [PDF]

eLetters: Submit a response to this article

Electronic letters published:

Is there a place for DAC?

Rudolf Gasko   (28 March 2005)

Is there a place for DAC? 28 March 2005
Rudolf Gasko, clinical biochemist Health Insurance Comp. Dovera, Murgasova 3, SK-043 25 Kosice, Slovakia Send letter to journal: Re: Is there a place for DAC? rudolf.gasko{at}netkosice.sk Rudolf Gasko	Method ROC curve analysis is widely used to characterise and compare diagnostic accuracies, but it isn't a gold standard, due to well known limitations (1). Many studies have aimed to develop better methods (2). The proposed discordance analysis characteristic seems to be good idea. Two difficulties - the necessity to define the corresponding pairs of cutoffs, and low absolute numbers in quadrants Q2 and Q4 in ranges of low sample density - are, in practice, serious. In my opinion, DAC approach is more suitable for test research than for diagnostic research. But, is there a place for test research (3)? Yes, of course. 1. Gasko R, Klimova E, Skicka L. Tissue Polypeptide-specific Antigen (TPS) and Carcinoembryonic Antigen (CEA) concentrations in cerebrospinal fluid in patients with breast cancer metastases. 6th IBRO World Congress of Neuroscience, Prague 2003, Abstract book, poster No 1360. 2. Haeckel R, Wosniok W, Puentmann I. Discordance rate, a new concept for combining diagnostic decisions with analytical performance characteristics. 1. Application in method or sample system comparisons and in defining decision limits. Clin Chem Lab Med 2003;41:347-355. 3. Moons KGM, Biesheuvel CJ, Grobbee DE. Test research versus diagnostic research. Clin Chem 2004;50:473-476.