Assessing diagnostic reliability and estimating incidence rates associated with a strictly progressive disease: Dental caries

A broad class of models is introduced to separate rater errors from underlying patterns of disease incidence, which can include covariates and risk factors and variance expressions for parameter estimates.

Abstract

This paper presents a general approach for simultaneously assessing, from serial data, diagnostic consistency, interrater reliability and incidence of a strictly progressive disease. Observed data are viewed as incomplete: diagnostic errors are not distinguished from true diagnoses. We introduce a broad class of models to separate rater errors from underlying patterns of disease incidence. The analysis can include covariates and risk factors. We provide variance expressions for parameter estimates. Categorical data for estimating the incidence of dental caries serve as an example.