Computer-based peak identification algorithms reduce observer bias in
the analysis of pulsatile hormone secretion. With increasing peak dete
ction stringency, an algorithm will detect varying proportions of true
-positive and false-positive peaks, determining its receiver-operated
characteristics (ROC). To demonstrate that ROC curve analysis can char
acterize algorithm performance, we analyzed growth hormone (hGH) profi
les from 94 children obtained with different hGH assay techniques [rad
ioimmunoassay (RIA), immunoradiometric assay (IRMA)] at different samp
ling intervals (group A: 1 h/RIA; group B: 1 h/IRMA; group C: 20 min/R
IA; group D: 20 min/IRMA), using the PULSAR and CLUSTER algorithms. Th
e area under the ROC curve (AUC) was taken to compare the efficacy of
both algorithms over a range of peak recognition stringency thresholds
kept constant between algorithms, using hGH noise series for threshol
d calibration and the results of multiple visual inspection as referen
ce standards. AUC by PULSAR ranged from 0.926 (group C) to 0.961 (grou
p A), indicating good algorithm performance. AUC by CLUSTER ranged fro
m 0.869 (group B) to 0.916 (group D) in the 20-min series, decreasing
to 0.756 (group C) and 0.868 (group A) in the 1-hour series. At lower
sampling intensity, significant discordant sensitivity existed between
algorithms for RIA (p < 0.001) and IRMA (p < 0.0026). When adjusted t
o a high, assay-specific, comparable stringency, and employed on 20-mi
n sampling hGH data, both the CLUSTER and PULSAR algorithm operated at
a similarly high peak detection efficacy. The PULSAR algorithm appear
s to be more robust when hGH series with lower sampling intensities ar
e analyzed. Until objective validation techniques become generally ava
ilable, we suggest that different algorithms be tested using reference
data sets and ROC curve analysis to select the most efficient algorit
hm and peak detection stringency threshold for the chosen assay and sa
mpling conditions.