Bayesian Estimation for Performance Measures of Two Diagnostic Tests in the Presence of Verification Bias

Sensitivity and specificity are measures that allow us to evaluate the performance of a diagnostic test. In practice, it is common to have situations where a proportion of selected individuals cannot have the real state of the disease verified, since the verification could be an invasive procedure, as occurs with biopsy. This happens, as a special case, in the diagnosis of prostate cancer, or in any other situation related to risks, that is, not practicable, nor ethical, or in situations with high cost. For this case, it is common to use diagnostic tests based only on the information of verified individuals. This procedure can lead to biased results or workup bias. In this paper, we introduce a Bayesian approach to estimate the sensitivity and the specificity for two diagnostic tests considering verified and unverified individuals, a result that generalizes the usual situation based on only one diagnostic test.

Comparing diagnostic tests with missing data

When missing data occur in studies designed to compare the accuracy of diagnostic tests, a common, though naive, practice is to base the comparison of sensitivity, specificity, as well as of positive and negative predictive values on some subset of the data that fits into methods implemented in standard statistical packages. Such methods are usually valid only under the strong missing completely at random (MCAR) assumption and may generate biased and less precise estimates. We review some models that use the dependence structure of the completely observed cases to incorporate the information of the partially categorized observations into the analysis and show how they may be fitted via a two-stage hybrid process involving maximum likelihood in the first stage and weighted least squares in the second. We indicate how computational subroutines written in R may be used to fit the proposed models and illustrate the different analysis strategies with observational data collected to compare the accuracy of three distinct non-invasive diagnostic methods for endometriosis. The results indicate that even when the MCAR assumption is plausible, the naive partial analyses should be avoided.

The STARD statement for reporting studies of diagnostic accuracy: Explanation and elaboration

The quality of reporting of studies of diagnostic accuracy is less than optimal. Complete and accurate reporting is necessary to enable readers to assess the potential for bias in the study and to evaluate the generalisability of the results. A group of scientists and editors has developed the STARD (Standards for Reporting of Diagnostic Accuracy) statement to improve the reporting the quality of reporting of studies of diagnostic accuracy. The statement consists of a checklist of 25 items and flow diagram that authors can use to ensure that all relevant information is present. This explanatory document aims to facilitate the use, understanding and dissemination of the checklist. The document contains a clarification of the meaning, rationale and optimal use of each item on the checklist, as well as a short summary of the available evidence on bias and applicability. The STARD statement, checklist, flowchart and this explanation and elaboration document should be useful resources to improve reporting of diagnostic accuracy studies. Complete and informative reporting can only lead to better decisions in healthcare.

External Bias Dependent Direct To Indirect Band Gap Transition in Graphene Nanoribbon

In this work, using self-consistent tight-binding calculations. for the first time, we show that a direct to indirect band gap transition is possible in an armchair graphene nanoribbon by the application of an external bias along the width of the ribbon, opening up the possibility of new device applications. With the help of the Dirac equation, we qualitatively explain this band gap transition using the asymmetry in the spatial distribution of the perturbation potential produced inside the nanoribbon by the external bias. This is followed by the verification of the band gap trends with a numerical technique using Magnus expansion of matrix exponentials. Finally, we show that the carrier effective masses possess tunable sharp characters in the vicinity of the band gap transition points.

Sophisticated security verification on routing repaired balanced cell-based dual-rail logic against side channel analysis

Conventional dual-rail precharge logic suffers from difficult implementations of dual-rail structure for obtaining strict compensation between the counterpart rails. As a light-weight and high-speed dual-rail style, balanced cell-based dual-rail logic (BCDL) uses synchronised compound gates with global precharge signal to provide high resistance against differential power or electromagnetic analyses. BCDL can be realised from generic field programmable gate array (FPGA) design flows with constraints. However, routings still exist as concerns because of the deficient flexibility on routing control, which unfavourably results in bias between complementary nets in security-sensitive parts. In this article, based on a routing repair technique, novel verifications towards routing effect are presented. An 8 bit simplified advanced encryption processing (AES)-co-processor is executed that is constructed on block random access memory (RAM)-based BCDL in Xilinx Virtex-5 FPGAs. Since imbalanced routing are major defects in BCDL, the authors can rule out other influences and fairly quantify the security variants. A series of asymptotic correlation electromagnetic (EM) analyses are launched towards a group of circuits with consecutive routing schemes to be able to verify routing impact on side channel analyses. After repairing the non-identical routings, Mutual information analyses are executed to further validate the concrete security increase obtained from identical routing pairs in BCDL.

Batch Verification of Validity of Bids in Homomorphic E-auction

Bid opening in e-auction is efficient when a homomorphic secret sharing function is employed to seal the bids and homomorphic secret reconstruction is employed to open the bids. However, this high efficiency is based on an assumption: the bids are valid (e.g., within a special range). An undetected invalid bid can compromise correctness and fairness of the auction. Unfortunately, validity verification of the bids is ignored in the auction schemes employing homomorphic secret sharing (called homomorphic auction in this paper). In this paper, an attack against the homomorphic auction in the absence of bid validity check is presented and a necessary bid validity check mechanism is proposed. Then a batch cryptographic technique is introduced and applied to improve the efficiency of bid validity check.

Correcting for bias when estimating the cost of hospital-acquired infection : an analysis of lower respiratory tract infections in non-surgical patients

Hospital acquired infections (HAI) are costly but many are avoidable. Evaluating prevention programmes requires data on their costs and benefits. Estimating the actual costs of HAI (a measure of the cost savings due to prevention) is difficult as HAI changes cost by extending patient length of stay, yet, length of stay is a major risk factor for HAI. This endogeneity bias can confound attempts to measure accurately the cost of HAI. We propose a two-stage instrumental variables estimation strategy that explicitly controls for the endogeneity between risk of HAI and length of stay. We find that a 10% reduction in ex ante risk of HAI results in an expected savings of £693 ($US 984).