Study Design and Analysis in Neuroradiology: A Practical Approach

摘要

As neuroradiologists, we often emphasize the importance of new imaging technologies as worthwhile and appropriate diagnostic tests for our patients. Through advanced imaging methods, we are able to study in depth the anatomic and physiological changes that affect the body as a result of disease. Quite often, however, we have a tendency to lose our perspective of how efficacious such neuroimaging actually is. As we become more heavily focused on the technical, anatomic, and physiological significance of imaging and its interpretation, it is easy to neglect the assessment of its relative clinical value through the use of appropriately designed studies that could determine diagnostic performance and efficacy. Although mastering the technical and interpretive aspects of the various imaging techniques is important, maintaining a proper clinical perspective through the use of sound studies aimed at determining efficacy and the effect imaging has on clinical outcome is fundamental to the advancement of our field. In the following essay, the necessary building blocks of an appropriate study design and analysis to assess the diagnostic performance and efficacy of a new test are introduced. To better understand these concepts, a hypothetical index case, which illustrates common features in any practical approach to study design and analysis in neuroradiology, is incorporated into the presentation.