Screening as an application of decision theory
N. T. Longford
Abstract
A decision-theoretical approach to setting the threshold for a screening
procedure that declares each examined subject as a positive or a negative
is developed.
It is fundamentally different from maximising the Youden index.
The method incorporates the consequences of the the two kinds
of bad decisions (false positives and false negatives)
by means of a set of plausible loss functions.
Details are presented for several classes of loss functions
and within-group distributions of the outcomes.
Extensions related to mixture distributions are outlined.
The method is applied to several examples.
In Statistics in Medicine, 32, 849-863, 2013.