Hello,

I have a case control study with a binary outcome (disease/no disease) and two clinical diagnosis "tests" which I would like to compare. The first "test" is binary (present/not present), the second is ordinal with a total of 4 categories (0=not present, 1=low suspicion, 2=moderate suspicion, 3=high suspicion). I also have two covariates that I need to adjust for in the analysis.

I have considered different methods for looking at sensitivity and specificity for these two tests but cannot decide on the best approach as I seem to run into limitations/questions with each method. I have read a lot about diagnostic accuracy and ROC analysis so I understand the concepts but struggling to implement.

I have considered:

1. logistic regression followed by estat classification with relevant cut-off --> how do I get 95% CIs for sensitivity and specificity? is there a way to obtain sens/spec (with 95% CIs) assuming covariate1=0, covariate 2=1 etc?

2. roctab --> is there a way to adjust for covariates?

3. roccurve/roc reg with covariate adjustments --> I've read some literature (Pepe et al 2009, 2003) that suggests you can do this with binary/ordinal classifiers but cannot find the stata code that allows this.

Appreciate any advice on any or all of the above.
Thank you!