The spectrum effect in tests for risk prediction, screening, and diagnosis
British Medical Journal
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Usher-Smith, J., Sharp, S., & Griffin, S. (2016). The spectrum effect in tests for risk prediction, screening, and diagnosis. British Medical Journal, 353 (i3139)https://doi.org/10.1136/bmj.i3139
The spectrum effect describes the variation between settings in performance of tests used to predict, screen for, and diagnose disease. In particular, the predictive use of a test may be different when it is applied in a general population rather than in the study sample in which it was first developed. This article discusses the impact of the spectrum effect on measures of test performance, and its implications for the development, evaluation, application, and implementation of such tests.
JUS is supported by a National Institute of Health Research (NIHR) Clinical Lectureship. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. SJS is supported by the Medical Research Council www.mrc.ac.uk [Unit Programme number MC_UU_12015/1].
Medical Research Council (MC_U106179474)
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External DOI: https://doi.org/10.1136/bmj.i3139
This record's URL: https://www.repository.cam.ac.uk/handle/1810/255949