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Application of Receiver Operating Characteristic Analysis

Jane M. Murphy, PhD; Donald M. Berwick, MD; Milton C. Weinstein, PhD; Jonathan F. Borus, MD; Simon H. Budman, PhD; Gerald L. Klerman, MD

Arch Gen Psychiatry. 1987;44(6):550-555.

Abstract
• Evaluation of psychiatric screening and diagnostic tests has benefited from the application of sensitivity, specificity, the K-statistic, and predictive values. These measures derive their meaning from a single criterion threshold. Receiver operating characteristic (ROC) analysis extends assessment of test performance by providing information about all possible pairs of achievable sensitivity and specificity values. The ROC analysis offers a comprehensive means for comparing different tests or different scoring procedures for one test. As a demonstration we used the ROC analysis to evaluate three types of scoring rules for one psychiatric test, the Health Opinion Survey. The demonstration indicated that ROC analysis can profitably take a place among the standard methods for test evaluation in psychiatric research. In addition, ROC analysis can assist clinicians in selecting appropriate test procedures for particular patient populations.

Author Affiliations
From the Mental Health Research Unit, Institute for Health Research, A Joint Program of the Harvard Community Health Plan and Harvard University and the Harvard Program in Psychiatric Epidemiology, Department of Psychiatry, Massachusetts General Hospital, Boston (Drs Murphy, Borus, and Klerman); and the Institute for Health Research, Boston (Drs Berwick, Weinstein, and Budman). Dr Klerman is now with the Department of Psychiatry, Cornell Medical School, New York.

Footnotes
Accepted for publication Sept 10, 1985.

Reprint requests to 703 Warren Bldg, Massachusetts General Hospital, Boston, MA 02114 (Dr Murphy).

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