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Estimating the Sensitivity of Holter to Detect Atrial Fibrillation After Stroke or Transient Ischemic Attack Without a Gold Standard is Challenging

Published:November 11, 2015DOI:https://doi.org/10.1016/j.amjcard.2015.11.004
      The sensitivity of a diagnostic test is ideally calculated by comparing the test assessments to a truth determined by another (perfect) test considered to be the gold standard. However, in many cases, there is no perfect gold standard.
      • Joseph L.G.
      • Gyorkos T.W.
      • Coupal L.
      Bayesian estimation of disease prevalence and the parameters of diagnostic tests in the absence of a gold standard.
      When it exists, assessment by the gold standard can be inaccessible, costly, or highly invasive. Using the best available but imperfect diagnostic test as gold standard can lead to substantial error in the estimation of diagnostic accuracy.
      • Joseph L.G.
      • Gyorkos T.W.
      • Coupal L.
      Bayesian estimation of disease prevalence and the parameters of diagnostic tests in the absence of a gold standard.
      The detection of atrial fibrillation (AF) after ischemic stroke is not an exception to this phenomenon.
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