A better confidence interval for the sensitivity at a fixed level of specificity for diagnostic tests with continuous endpoints

Abstract

For a diagnostic test with continuous measurement, it is often important to construct confidence intervals for the sensitivity at a fixed level of specificity. Bootstrap-based confidence intervals were shown to have good performance as compared to others, and the one by Zhou and Qin (2005) was recommended as the best existing confidence interval, named the BTII interval. We propose two new confidence intervals based on the profile variance method and conduct extensive simulation studies to compare the proposed intervals and the BTII intervals under a wide range of conditions. An example from a medical study on severe head trauma is used to illustrate application of the new intervals. The new proposed intervals generally have better performance than the BTII interval.