#### II. Definitions

1. Receiver Operating Characteristic (ROC)
1. Graphical representation of balance between Test Sensitivity and Test Specificity
2. Test Criterion
1. Threshold for which a test is considered positive
2. A Screening Test may set the test criterion low to minimize False Negatives (at the expense of increased False Positives)
3. A confirmatory test may set the test criterion high to minimize False Positives (at the expense of increased False Negatives)

#### III. Technique

1. Given a range of test criteria (from low threshold to high threshold)
1. Identify the Test Sensitivity and Test Specificity at each of the test criteria
2. For each test criteria, plot the Test Sensitivity and 1-Test Specificity
1. True Positive Rate (Test Sensitivity)
1. Plot on Y axis
2. False Positive Rate (1-Test Specificity)
1. Plot on X axis

#### IV. Interpretation

1. Identify the Shoulder or inflection point in the curve as the optimal threshold
2. Best tests have maximal area under the curve (AUC)
1. Most distinct, highest inflection point best distinguishes between positive and negative test
2. Poor tests, have no inflection point
1. Flat, linear relationship between Test Sensitivity and 1-Test Specificity at various test criteria

#### V. Resources

1. Receiver Operating Characteristic (Wikipedia)
1. https://en.wikipedia.org/wiki/Receiver_operating_characteristic

#### VI. References

1. Desai (2014) Clinical Decision Making, AMIA’s CIBRC Online Course

### Ontology: ROC Curve (C0035787)

 Definition (MSH) A graphic means for assessing the ability of a screening test to discriminate between healthy and diseased persons; may also be used in other studies, e.g., distinguishing stimuli responses as to a faint stimuli or nonstimuli. Concepts Quantitative Concept (T081) MSH D012372 English Analyses, ROC, Analysis, ROC, Curve, ROC, Curves, ROC, ROC Analyses, ROC Analysis, ROC Curve, ROC Curves, ROC ANAL, ANAL ROC, roc curve, roc analysis Swedish ROC-kurvanalys Czech ROC křivka Finnish ROC-käyrä French Analyse ROC, Courbe ROC (Receiver Operating Characteristic), Courbe ROC Russian SKRININGA OTSENOCHNAIA KRIVAIA, RABOCHIE KHARAKTERISTIKI, ANALIZ, RKH-ANALIZ, РАБОЧИЕ ХАРАКТЕРИСТИКИ, АНАЛИЗ, РХ-АНАЛИЗ, СКРИНИНГА ОЦЕНОЧНАЯ КРИВАЯ Japanese ROC分析, 受信者動作特性曲線, 受信者特性曲線, 受信者動作特性, 受信者操作特性曲線, 等感受性曲線, ROC解析, ROC曲線 Italian Analisi ROC, Curva ROC Polish Krzywa ROC, Charakterystyka skuteczności percepcji Norwegian ROC-analyse, ROC-kurveanalyse German ROC-Analyse, ROC-Kurve Dutch ROC-analyse, ROC-curve Portuguese Análise ROC, Curva ROC Spanish Análisis ROC, Curva ROC