title: Differentiation of benign and malignant breast tumors by logistic regression and a classification tree using Doppler flow signals.
abstract: In breast examinations with Doppler, an increased flow is found in malignant tumors. With the relatively new color Doppler, we measured different flow values in 133 cancer patients and in 325 women with benign disease. These measurements were used to develop diagnostic rules. For the highly correlated flow values, we used a stepwise procedure to select a final logistic regression model and a tree-based approach, which is a different way of modeling. With both approaches we developed simple diagnostic rules of which the sensitivity and the specificity exceeded 90%. There are no differences between the two approaches concerning discriminative ability. As complex statistical modeling leads to an overoptimism in the assessment of the error rates, we applied sensitivity analysis, investigated the stability of the selected logistic regression model, and estimated the magnitude of the overoptimism of the diagnostic rules with resampling methods. The results indicate that the estimates of sensitivity and specificity are probably close to realistic values for a clinical setting.
authors.affiliation: Institute of Medical Biometry and Informatics, University of Freiburg, Germany. wfs@imbi.uni-freiburg.de
authors.forename: W
authors.initials: W
authors.lastname: Sauerbrei
authors.forename: H
authors.initials: H
authors.lastname: Madjar
authors.forename: H J
authors.initials: HJ
authors.lastname: Prömpeler
mesh_terms: D001783:Blood Flow Velocity / Q000502:physiology; D001943:Breast Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging*; D003663:Decision Trees; D003937:Diagnosis, Differential; D005260:Female; D005348:Fibrocystic Breast Disease / Q000000981:diagnostic imaging*; D006801:Humans; D016015:Logistic Models; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler / Q000145:classification*; D016217:Ultrasonography, Mammary / Q000145:classification*