Abstract:
A new method to assess the relative difficulty of a medical diagnosis and the efficacy
of a diagnostic procedure is described. The cases within a population are classified
by N independent interpreters, i. e., medical experts or computer programs. The percentages
of correctly diagnosed cases by N (unanimity), N-1, N-2, ..., zero interpreters, respectively,
are calculated. These Nl + 1 percentages are presented in a histogram. A cumulative
plot is derived from the “unanimity” value. The ratio “unanimity value”/“zero value”
is proposed as an index of diagnostic performance. An application to the CSE database
is presented which is composed of 1,220 electrocardiographic tracings interpreted
by 13 cardiologists and 15 computer programs. The cumulative plots, the performance
index and Log (index) values, established for eight different diagnostic statements,
clearly show the relative degree of diagnostic difficulty for each of them and the
particular efficacy of each approach, i. e., electrocardiography versus vectorcardiography,
and computerized versus human interpretation.
Key-words
Diagnostic Performance - Evaluation - Human Interpretation - Computer-assisted Interpretation
- Electrocardiography - Vectorcardiography
