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<p>Five years ago, Korevaar and colleagues proposed a framework for designing diagnostic accuracy studies, focusing on the definition of clear study hypotheses. This proposal filled a gap and was well received by the scientific community. In this commentary, I suggest five potential refinements. They aim at increasing the flexibility of the framework while pertaining its logical consistency. The refinements address the following five topics: (1) The relationship between minimal criteria and the choice of the null hypothesis region; (2) The potential to allow compensation between sensitivity and specificity; (3) The possibility to use other pairs than sensitivity and specificity; (4) The potential phrasing as an estimation problem; (5) The advantages of directly moving to a comparative accuracy study.</p>

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Targeted test evaluation: five suggestions for refining the framework for designing diagnostic accuracy studies with clear study hypotheses

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  • 发表日期：

    2025年11月4日

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  • Werner Vach

摘要

Five years ago, Korevaar and colleagues proposed a framework for designing diagnostic accuracy studies, focusing on the definition of clear study hypotheses. This proposal filled a gap and was well received by the scientific community. In this commentary, I suggest five potential refinements. They aim at increasing the flexibility of the framework while pertaining its logical consistency. The refinements address the following five topics: (1) The relationship between minimal criteria and the choice of the null hypothesis region; (2) The potential to allow compensation between sensitivity and specificity; (3) The possibility to use other pairs than sensitivity and specificity; (4) The potential phrasing as an estimation problem; (5) The advantages of directly moving to a comparative accuracy study.