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ROC and Loss Function Analysis in Sequential Testing

Content Provider	Springer Nature Link
Author	Muijtjens, Ar M. M. Luijk, Scheltus J. Vleuten, Cees P. M.
Copyright Year	2006
Abstract	Sequential testing is applied to reduce costs in SP-based tests (OSCEs). Initially, all candidates take a screening test consisting of a part of the OSCE. Candidates who fail the screen sit the complete test, whereas those who pass the screen are qualified as a pass of the complete test. The procedure may result in a reduction of testing resources, but at the cost of false positives (candidates who pass the screen but would fail the complete test). In a diagnostic test an optimum cutpoint is obtained by minimizing the weighted sum of false negatives and false positives using Receiver Operator Characteristic (ROC) analysis. However, in the sequential procedure there are no false negatives, because the result of the complete test is considered the final outcome. Several authors ignored this difference and applied classic ROC analysis to a sequential test. Earlier, we doubted the validity of the procedure and proposed to set the cutpoint by minimizing the loss, defined as the weighted sum of the screen negatives and the false positives. Recently, Regehr and Colliver (2003) argued that under certain theoretically derived conditions the use of the loss formula in sequential testing is functionally identical to using classic ROC analysis. The current study shows (a) the conclusion of Regehr and Colliver is based on assumptions that can be challenged, and (b) ROC analysis indeed can be used in sequential testing, but only if the procedure is modified according to the results of a corresponding loss function analysis.
Starting Page	5
Ending Page	17
Page Count	13
File Format	PDF
ISSN	13824996
Journal	Advances in Health Sciences Education
Volume Number	11
Issue Number	1
e-ISSN	15731677
Language	English
Publisher	Kluwer Academic Publishers
Publisher Date	2006-01-01
Publisher Place	Dordrecht
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	diagnostic test false negatives false positives loss function OSCE Receiver Operator Characteristic ROC analysis sequential test SP-based test Medical Education
Content Type	Text
Resource Type	Article
Subject	Education Medicine

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