title: Diagnostic performance analysis for diabetic cardiovascular autonomic neuropathy based on short-term heart rate variability using Bayesian methods: preliminary analysis.
abstract: OBJECTIVE
  This study aimed to estimate the performance of diabetic cardiovascular autonomic neuropathy (DCAN) diagnostic tests in the absence of a gold standard.
  
  
  BACKGROUND
  The DCAN prevalence is rapidly growing in all populations worldwide. No document has been reported about diagnostic performance for DCAN based on short-term HRV without a gold standard.
  
  
  METHODS
  We conducted a cross-sectional study to perform diagnostic test in Chinese diabetic patients. A dataset contained 56 subjects who completed both the short-term HRV test and Ewing's test. Simultaneous inferences about the population prevalence and the performance of each diagnostic test were possible using the Bayesian approach.
  
  
  RESULTS
  The HRV test had a high sensitivity (0.837 and 0.821 for independence model) and specificity (0.838 and 0.797 for dependence model) to DCAN. In addition, the non-inferiority test rejected the hypothesis that the performance of the HRV test was inferior to that of Ewing's test (P < 0.05). The estimated DCAN prevalence in our study sample was more than 0.400.
  
  
  CONCLUSIONS
  Our findings provided evidence that short-term HRV were used for the DCAN diagnostic test with a high sensitivity and specificity. ClinicalTrial.org ID: NCT02461381.
authors.affiliation: Department of Internal Medicine, The People's Hospital of Mengzi, Honghe, Yunnan China.
authors.forename: Jun
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Internal Medicine, The People's Hospital of Mengzi, Honghe, Yunnan China.
authors.forename: Shuang-Bin
authors.initials: SB
authors.lastname: Yang
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Tongji Hospital, Tongji University School of Medicine, Rm 1520 Building 6th, No. 389 Xincun Road, Shanghai, 200065 China.
authors.forename: Juanmei
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Tongji Hospital, Tongji University School of Medicine, Rm 1520 Building 6th, No. 389 Xincun Road, Shanghai, 200065 China.
authors.forename: Zi-Hui
authors.initials: ZH
authors.lastname: Tang
keywords: Bayesian estimation; Diabetic cardiovascular autonomic neuropathy; Heart rate variability; Without a gold standard