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Analyzes how diagnostic accuracy changes when applying two tests in sequence, comparing three different testing strategies: serial positive (confirmation), serial negative (exclusion), and parallel testing. Provides comprehensive analysis including population flow, cost implications, and Fagan nomograms.

Usage

sequentialtests(
  preset = "custom",
  test1_name = "Screening Test",
  test1_sens = 0.95,
  test1_spec = 0.7,
  test1_cost = 0,
  test2_name = "Confirmatory Test",
  test2_sens = 0.8,
  test2_spec = 0.98,
  test2_cost = 0,
  strategy = "serial_positive",
  prevalence = 0.1,
  population_size = 1000,
  show_explanation = FALSE,
  show_formulas = FALSE,
  show_cost_analysis = FALSE,
  show_nomogram = FALSE
)

Arguments

preset

Select a clinical preset or use custom values. Presets load evidence-based test parameters and optimal strategies from medical literature.

test1_name

.

test1_sens

.

test1_spec

.

test1_cost

.

test2_name

.

test2_sens

.

test2_spec

.

test2_cost

.

strategy

.

prevalence

.

population_size

Population size used to illustrate population flow counts. Does not affect probabilities.

show_explanation

.

show_formulas

.

show_cost_analysis

.

show_nomogram

.

Value

A results object containing:

results$plain_summarya html
results$summary_tablea table
results$individual_tests_tablea table
results$population_flow_tablea table
results$cost_analysis_tablea table
results$explanation_texta html
results$formulas_texta html
results$plot_flow_diagraman image
results$plot_performancean image
results$plot_probabilityan image
results$plot_population_flowan image
results$plot_sensitivity_analysisan image
results$clinical_guidancea html
results$noticesa html

Tables can be converted to data frames with asDF or as.data.frame. For example:

results$summary_table$asDF

as.data.frame(results$summary_table)

Details

This analysis is particularly useful for: • Designing diagnostic protocols and clinical pathways • Optimizing test sequencing for specific clinical contexts • Understanding trade-offs between sensitivity and specificity • Evaluating cost-effectiveness of different testing strategies • Teaching sequential testing concepts and Bayesian probability

Examples

# \donttest{
# example will be added
# }