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DOI: 10.1148/radiol.2281020709
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(Radiology 2003;228:10-14.)
© RSNA, 2003

Special Reports

Prevalence Effect in a Laboratory Environment1

David Gur, ScD, Howard E. Rockette, PhD, Derek R. Armfield, MD, Arye Blachar, MD, Jennifer K. Bogan, MD, Giuseppe Brancatelli, MD, Cynthia A. Britton, MD, Manuel L. Brown, MD, Peter L. Davis, MD, James V. Ferris, MD, Carl R. Fuhrman, MD, Sara K. Golla, MD, Sanj Katyal, MD, Joan M. Lacomis, MD, Barry M. McCook, MD, F. Leland Thaete, MD and Thomas E. Warfel, MD, PhD

1 From Department of Radiology, Imaging Research, Suite 4200, University of Pittsburgh, 300 Halket St, Pittsburgh, PA 15213-3180. Supported by grant CA84507 from the National Cancer Institute, National Institutes of Health. Received June 14, 2002; revision requested August 8; revision received September 6; accepted October 21. Address correspondence to (e-mail: gurd@msx.upmc.edu).

PURPOSE: To measure observer performance at various levels of prevalence.

MATERIALS AND METHODS: A multiobserver multiabnormality receiver operating characteristic (ROC) study to assess the effect of prevalence on observer performance was conducted. Fourteen observers, including eight faculty members, two fellows, and four residents, interpreted 1,632 posteroanterior chest images with five prevalence levels by using a nested study design. Performance comparisons were accomplished by using a multireader multicase approach to assess the effect of prevalence from 28% (69 of 249) to 2% (31 of 1,577) on diagnostic accuracy. The mean times required to review and report a case were analyzed and compared for different levels of prevalence and readers’ experience.

RESULTS: Area under the ROC curve demonstrated that, with the study experimental conditions, no significant effect could be measured as a function of prevalence (P > .05) for any abnormality, group of cases, or readers. There were no significant differences (P > .05) in the mean times required to review and report cases at different prevalence levels and with different groups of readers.

CONCLUSION: The consistency in the results and the size of this study suggest that with laboratory conditions, if a prevalence effect exists, it is quite small in magnitude; hence, it will not likely alter conclusions derived from such studies.

© RSNA, 2003

Index terms: Diagnostic radiology, observer performance • Receiver operating characteristic (ROC) curve • Statistical analysis




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