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Understanding receiver operating characteristic (ROC) curves

  • Jerome Fan (a1), Suneel Upadhye (a1) and Andrew Worster (a1)

Extract

In this issue of the Journal, Auer and colleagues conclude that serum levels of neuron-specific enolase (NSE), a biochemical marker of ischemic brain injury, may have clinical utility for the prediction of survival to hospital discharge in patients experiencing the return of spontaneous circulation following at least 5 minutes of cardiopulmonary resuscitation. The authors used a receiver operating characteristic (ROC) curve to illustrate and evaluate the diagnostic (prognostic) performance of NSE. We explain ROC curve analysis in the following paragraphs.

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Copyright

COPYRIGHT: © Canadian Association of Emergency Physicians 2006

Corresponding author

Emergency Department, Hamilton Health Sciences, McMaster University Medical Centre, 1200 Main St. W, Hamilton ON L8N 3Z5

References

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1.Auer, J, Berent, R, Weber, T, et al. Ability of neuron-specific enolase to predict survival to hospital discharge after successful cardiopulmonary resuscitation. Can J Emerg Med 2006;8(1):13–8.
2.Lusted, LB. Decision-making studies inpatient management. N Engl J Med 1971; 284:416–24.
3.Grzybowski, M, Younger, JG. Statistical methodology: III. Receiver operating characteristic (ROC) curves. Acad Emerg Med 1997;4:818–26.
4.Worster, A, Innes, G, Abu-Laban, RB. Diagnostic testing: an emergency medicine perspective. Can J Emerg Med 2002;4(5): 348–54.
5.Faraggi, D, Reiser, B. Estimation of the area under the ROC curve. Stat Med 2002;21:3093–106.
6.Deeks, J. Systematic reviews of evaluations of diagnostic and screening tests. In: Egger, M, Smith, GD, Altman, DG, editors. Systematicreviews in health care: meta-analysis in context. BMJ Publishing Group; 2001.

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