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Overrating Classifier Performance in ROC Analysis in the Absence of a Test Set: Evidence from Simulation and Italian CARATkids Validation

dc.contributor.authorCilluffo, G
dc.contributor.authorFasola, SJ
dc.contributor.authorFerrante, G
dc.contributor.authorMontalbano, L
dc.contributor.authorBaiardini, I
dc.contributor.authorIndinnimeo, L
dc.contributor.authorViegi, G
dc.contributor.authorFonseca, JA
dc.contributor.authorLa Grutta, S
dc.date.accessioned2020-03-15T18:29:42Z
dc.date.available2020-03-15T18:29:42Z
dc.date.issued2019
dc.description.abstractBACKGROUND: The use of receiver operating characteristic curves, or "ROC analysis," has become quite common in biomedical research to support decisions. However, sensitivity, specificity, and misclassification rates are still often estimated using the training sample, overlooking the risk of overrating the test performance. METHODS: A simulation study was performed to highlight the inferential implications of splitting (or not) the dataset into training and test set. The normality assumption was made for the classifier given the disease status, and the Youden's criterion considered for the detection of the optimal cutoff. Then, an ROC analysis with sample split was applied to assess the discriminant validity of the Italian version of the Control of Allergic Rhinitis and Asthma Test (CARATkids) questionnaire for children with asthma and rhinitis, for which recent studies may have reported liberal performance estimates. RESULTS: The simulation study showed that both single split and cross-validation (CV) provided unbiased estimators of sensitivity, specificity, and misclassification rate, therefore allowing computation of confidence intervals. For the Italian CARATkids questionnaire, the misclassification rate estimated by fivefold CV was 0.22, with 95% confidence interval 0.14 to 0.30, indicating an acceptable discriminant validity. CONCLUSIONS: Splitting into training and test set avoids overrating the test performance in ROC analysis. Validated through this method, the Italian CARATkids is valid for assessing disease control in children with asthma and rhinitis.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationMethods Inf Med. 2019 Dec;58(S 02):e27-e42.pt_PT
dc.identifier.doi10.1055/s-0039-1693732pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.26/31738
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.subjectAsmapt_PT
dc.subjectRinite Alérgicapt_PT
dc.subjectAsthmapt_PT
dc.subjectRhinitis, Allergicpt_PT
dc.titleOverrating Classifier Performance in ROC Analysis in the Absence of a Test Set: Evidence from Simulation and Italian CARATkids Validationpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPagee42pt_PT
oaire.citation.issueS 02pt_PT
oaire.citation.startPagee27-e42pt_PT
oaire.citation.titleMethods of information in medicinept_PT
oaire.citation.volume58pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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