Discriminatory accuracy of serological tests for detecting Trypanosoma cruzi using the ROC curve and the standard methodology

Introduction: Serological tests are used to confirm Trypanosoma cruzi infection and their discriminatory accuracy depends on the established decision threshold. Both, the standard methodology and the receiver operating characteristic (ROC) curve methodology allow obtaining such threshold. Objective:...

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Published in:Revista de la Facultad de Medicina, Universidad Nacional de Colombia Universidad Nacional de Colombia, 2020-01, Vol.68 (1), p.107-116
Main Authors: Querales, Marvin, De Lima, Ana Rita, Martínez-de Cordero, Harú, Cannova, Domenica Carolina, Simons, María Isabel, Pérez-Ybarra, Luis
Format: Article
Language:English
Subjects:
Accuracy
Chagas disease
Curva ROC
MEDICINE, GENERAL & INTERNAL
Protozoa
ROC Curve
Sensibilidad y especificidad
Sensitivity and Specificity
Serology
Serología
Trypanosoma cruzi
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Summary:Introduction: Serological tests are used to confirm Trypanosoma cruzi infection and their discriminatory accuracy depends on the established decision threshold. Both, the standard methodology and the receiver operating characteristic (ROC) curve methodology allow obtaining such threshold. Objective: To compare the discriminatory accuracy of the standard methodology and the ROC curve methodology regarding serological tests for confirming T. cruzi infection. Materials and methods: A set of anti-T. cruzi antibodies values from subjects previously classified as healthy or as having Chagas disease were used, and computer simulations were performed under homoscedasticity and heteroscedasticity conditions. Sensitivity, specificity, 100% sensitivity, 100% specificity, and perfect-decision were calculated. Results:The discriminatory accuracy obtained with the standard methodology favored specificity (98.22% to 99.56%) over sensitivity (67.25% to 87.14%), while in the ROC curve methodology a balance between sensitivity (94.56% and 96.44%) and specificity (90.35% and 92.11%) was observed. Also, in the ROC curve methodology a greater perfect-decision ratio was observed, which, under homoscedasticity conditions, was >90%. Decisions thresholds were affected by heteroscedasticity conditions. Conclusion: The ROC curve methodology showed better discriminatory accuracy, therefore its use for calculating decision thresholds in serological tests for detecting Chagas disease is recommended.
ISSN:0120-0011
2357-3848
2357-3848
DOI:10.15446/revfacmed.v68n1.71092