Bayesian Sample Size Determination for Prevalence and Diagnostic Test Studies in the Absence of a Gold Standard Test
Bibliographic record
Abstract
Planning studies involving diagnostic tests is complicated by the fact that virtually no test provides perfectly accurate results. The misclassification induced by imperfect sensitivities and specificities of diagnostic tests must be taken into account, whether the primary goal of the study is to estimate the prevalence of a disease in a population or to investigate the properties of a new diagnostic test. Previous work on sample size requirements for estimating the prevalence of disease in the case of a single imperfect test showed very large discrepancies in size when compared to methods that assume a perfect test. In this article we extend these methods to include two conditionally independent imperfect tests, and apply several different criteria for Bayesian sample size determination to the design of such studies. We consider both disease prevalence studies and studies designed to estimate the sensitivity and specificity of diagnostic tests. As the problem is typically nonidentifiable, we investigate the limits on the accuracy of parameter estimation as the sample size approaches infinity. Through two examples from infectious diseases, we illustrate the changes in sample sizes that arise when two tests are applied to individuals in a study rather than a single test. Although smaller sample sizes are often found in the two-test situation, they can still be prohibitively large unless accurate information is available about the sensitivities and specificities of the tests being used.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.343 | 0.737 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.005 | 0.003 |
| Bibliometrics | 0.007 | 0.004 |
| Science and technology studies | 0.002 | 0.010 |
| Scholarly communication | 0.004 | 0.006 |
| Open science | 0.006 | 0.005 |
| Research integrity | 0.008 | 0.006 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".