Screening as an application of decision theory
N. T. Longford
Abstract
Decision theory is applied to the problem of setting thresholds
in medical screening when it is organised in two stages.
In the first stage, which involves a less expensive procedure
that can be applied on a mass scale,
an individual is classified as a negative or a likely positive.
In the second stage, the likely positives are subjected to another test
that classifies them as (definite) positives or negatives.
The second-stage test is more accurate,
but also more expensive and more involved, and so
there are incentives to restrict its application.
Robustness of the method with respect to the parameters,
some of which have to be set by elicitation,
is assessed by sensitivity analysis.
To appear in Statistics in Medicine, 34, 2015.