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Dataset with 140 patients where two tests show low agreement. Tests have moderate and different diagnostic characteristics (Sens: 0.70, 0.65; Spec: 0.80, 0.75).

Usage

nogoldstandard_lowagreement

Format

A data frame with 140 rows and 3 variables:

patient_id

Character: Patient identifier (PT001-PT140)

Test1

Factor: First test ("Negative", "Positive"), Sens=0.70, Spec=0.80

Test2

Factor: Second test ("Negative", "Positive"), Sens=0.65, Spec=0.75

age

Numeric: Patient age in years (mean 58, SD 14)

Source

Generated test data for ClinicoPath package

Details

Simulated with 30% prevalence. Tests have low correlation, representing tests measuring different aspects of disease.

Examples

data(nogoldstandard_lowagreement)
nogoldstandard(data = nogoldstandard_lowagreement,
               test1 = "Test1", test1Positive = "Positive",
               test2 = "Test2", test2Positive = "Positive",
               test3Positive = "", test4Positive = "",
               test5Positive = "")
#> 
#>  ANALYSIS WITHOUT GOLD STANDARD
#> 
#>  Agreement Statistics (Cohen's Kappa)                      
#>  ───────────────────────────────────────────────────────── 
#>    Test Pair         Kappa        p-value      Agreement   
#>  ───────────────────────────────────────────────────────── 
#>    Test1 vs Test2    0.2295840    0.0085860     64.28571   
#>  ───────────────────────────────────────────────────────── 
#> 
#> 
#>  <div class='clinical-summary' style='background: #f0f8ff; padding:
#>  15px; border-radius: 8px; margin: 10px 0;'><h4 style='color: #1565c0;
#>  margin-top: 0;'> Clinical Summary
#> 
#>  Analysis: No gold standard analysis using all_positive method
#> 
#>  Tests analyzed: Test1, Test2 (N=2)
#> 
#>  Disease prevalence: 18.6%
#> 
#>  Test sensitivities: Range from 100.0% to 100.0%
#> 
#>  Clinical interpretation: Moderate prevalence setting - balanced
#>  diagnostic performance
#> 
#>  <div style='background: #f8f9fa; padding: 20px; border-radius: 8px;
#>  margin: 15px 0; border-left: 4px solid #007bff;'><h3 style='color:
#>  #007bff; margin-top: 0;'> Method Selection Guide
#> 
#>  <div style='margin: 15px 0; padding: 15px; background: #e8f5e8;
#>  border-radius: 5px;'><h4 style='color: #2e7d32; margin-top: 0;'>
#>  Latent Class Analysis (Recommended)
#> 
#>  Description: Most robust method using mixture models. Estimates
#>  disease prevalence and test parameters simultaneously.
#> 
#>  Best for: Diagnostic validation studies with 3+ tests and N>=100
#> 
#>  Strengths: Handles conditional dependence, provides model fit
#>  statistics, most statistically rigorous
#> 
#>  <div style='margin: 15px 0; padding: 15px; background: #e3f2fd;
#>  border-radius: 5px;'><h4 style='color: #1565c0; margin-top: 0;'>
#>  Bayesian Analysis
#> 
#>  Description: Incorporates prior knowledge about test performance using
#>  Bayesian methods.
#> 
#>  Best for: Studies where you have prior information about expected
#>  sensitivity/specificity
#> 
#>  Strengths: Uses prior knowledge, handles uncertainty well, good for
#>  smaller samples
#> 
#>  <div style='margin: 15px 0; padding: 15px; background: #fff3e0;
#>  border-radius: 5px;'><h4 style='color: #ef6c00; margin-top: 0;'>
#>  Composite Reference
#> 
#>  Description: Uses majority vote of available tests as pseudo-gold
#>  standard.
#> 
#>  Best for: Inter-rater agreement studies with 3+ tests, exploratory
#>  analysis
#> 
#>  Strengths: Simple and intuitive, requires minimal assumptions, good
#>  starting point
#> 
#>  <div style='margin: 15px 0; padding: 15px; background: #fce4ec;
#>  border-radius: 5px;'><h4 style='color: #c2185b; margin-top: 0;'> All
#>  Tests Positive
#> 
#>  Description: Conservative approach - disease present only if ALL tests
#>  are positive.
#> 
#>  Best for: Highly specific diagnoses where false positives are very
#>  costly
#> 
#>  Strengths: High specificity reference, minimizes false positives
#> 
#>  <div style='margin: 15px 0; padding: 15px; background: #e8f5e8;
#>  border-radius: 5px;'><h4 style='color: #388e3c; margin-top: 0;'> Any
#>  Test Positive
#> 
#>  Description: Liberal approach - disease present if ANY test is
#>  positive.
#> 
#>  Best for: Population screening scenarios where missing cases is costly
#> 
#>  Strengths: High sensitivity reference, minimizes false negatives
#> 
#>  <div style='margin: 15px 0; padding: 10px; background: #fff8e1;
#>  border-radius: 5px; border-left: 3px solid #ffb300;'><h4 style='color:
#>  #e65100; margin-top: 0;'> Selection Tips
#> 
#>  Start with Latent Class Analysis for most diagnostic studiesUse
#>  Composite Reference for quick exploratory analysisChoose All/Any Tests
#>  Positive based on clinical consequences of errorsConsider Bayesian if
#>  you have strong prior information
#> 
#>  Disease Prevalence                      
#>  ─────────────────────────────────────── 
#>    Estimate     Lower CI     Upper CI    
#>  ─────────────────────────────────────── 
#>     18.57143     12.12981     25.01305   
#>  ─────────────────────────────────────── 
#> 
#> 
#>  Test Performance Metrics                                                                                              
#>  ───────────────────────────────────────────────────────────────────────────────────────────────────────────────────── 
#>    Test     Sensitivity    Lower CI     Upper CI     Specificity    Lower CI     Upper CI     PPV          NPV         
#>  ───────────────────────────────────────────────────────────────────────────────────────────────────────────────────── 
#>    Test1      100.00000    100.00000    100.00000       79.82456     73.17698     86.47215     53.06122    100.00000   
#>    Test2      100.00000    100.00000    100.00000       76.31579     69.27339     83.35819     49.05660    100.00000   
#>  ───────────────────────────────────────────────────────────────────────────────────────────────────────────────────── 
#> 
#> 
#>  Test Cross-Tabulation                       
#>  ─────────────────────────────────────────── 
#>    Test Combination    Count    Percentage   
#>  ─────────────────────────────────────────── 
#>    Test1-, Test2-         64      45.71429   
#>    Test1-, Test2+         27      19.28571   
#>    Test1+, Test2+         26      18.57143   
#>    Test1+, Test2-         23      16.42857   
#>  ─────────────────────────────────────────── 
#>