APPLICATIONS IN VARIOUS DIAGNOSTIC FIELDS
Seven chapters here describe applications of ROC methods to evaluate the performance of diagnostic techniques in several different fields. The first three treat imaging techniques, such as X-ray and computed tomography ("CAT scans"), in clinical medicine. The third of these shows how discrimination acuity or diagnostic accuracy can be enhanced as well as evaluated.
The first medical chapter reviews some fifteen of the earliest evaluations to use ROC methods and then considers some methodological issues that arose in medicine as well as previously in the psychology laboratory. These issues include the measurement of performance from a single ROC point; going beyond lesion detection to lesion localization and/or classification of lesion type; and the use of two or more imaging techniques in combination to make a single decision. The second medical chapter describes a large-scale evaluation of computed tomography as a then new imaging modality thought likely to be a preferable alternative to the then current modality (radionuclide imaging) for the diagnosis of brain lesions.
The third medical chapter focuses on enhancing diagnostic accuracy and on the implications of enhancement for evaluation. The example used is X-ray mammography in the diagnosis of breast cancer. Various psychological and statistical procedures are used to determine which perceptual features of a mammogram are diagnostically relevant and the extent to which they are relevant (predictive of cancer). A checklist of features is then prepared for