An improved measure for comparing diagnostic tests

We present a loss based method for comparing the predictive performance of diagnostic tests. Unlike standard assessment mechanisms, like the area unde r the receiver-operating characteristic curve and the misclassification rat e, our method takes specific advantage of any information that can be obtai ned about misclassification costs. We argue that not taking costs into acco unt can lead to incorrect conclusions, and illustrate with two examples. (C ) 2000 Elsevier Science Ltd. All rights reserved.