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DOI: 10.1148/radiol.2291010898
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(Radiology 2003;229:3-8.)
© RSNA, 2003

Statistical Concepts Series

Receiver Operating Characteristic Curves and Their Use in Radiology1

Nancy A. Obuchowski, PhD

1 From the Department of Biostatistics and Epidemiology/Wb4, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195. Received May 8, 2001; revision requested June 11; revision received August 1; accepted August 2. Address correspondence to the author (e-mail: nobuchow@bio.ri.ccf.org).

Sensitivity and specificity are the basic measures of accuracy of a diagnostic test; however, they depend on the cut point used to define "positive" and "negative" test results. As the cut point shifts, sensitivity and specificity shift. The receiver operating characteristic (ROC) curve is a plot of the sensitivity of a test versus its false-positive rate for all possible cut points. The advantages of the ROC curve as a means of defining the accuracy of a test, construction of the ROC, and identification of the optimal cut point on the ROC curve are discussed. Several summary measures of the accuracy of a test, including the commonly used percentage of correct diagnoses and area under the ROC curve, are described and compared. Two examples of ROC curve application in radiologic research are presented.

© RSNA, 2003

Index terms: Diagnostic radiology • Statistical analysis




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