Statistical inference for the difference between two maximized Youden indices obtained from correlated biomarkers

Leonidas E. Bantis, Christos T. Nakas, Benjamin Reiser

Research output: Contribution to journalArticlepeer-review

Abstract

Currently, there is global interest in deriving new promising cancer biomarkers that could complement or substitute the conventional ones. Clinical decisions can often be based on the cutoff that corresponds to the maximized Youden index when maximum accuracy drives decisions. When more than one classification criteria are measured within the same individuals, correlated measurements arise. In this work, we propose hypothesis tests and confidence intervals for the comparison of two correlated receiver operating characteristic (ROC) curves in terms of their corresponding maximized Youden indices. We explore delta-based techniques under parametric assumptions, or power transformations. Nonparametric kernel-based methods are also examined. We evaluate our approaches through simulations and illustrate them using data from a metabolomic study referring to the detection of pancreatic cancer.

Original languageEnglish
Pages (from-to)1241-1253
Number of pages13
JournalBiometrical Journal
Volume63
Issue number6
DOIs
StatePublished - Aug 2021

Bibliographical note

Publisher Copyright:
© 2021 Wiley-VCH GmbH

Keywords

  • Box–Cox transformation
  • Youden index
  • receiver operating characteristic curve
  • sensitivity
  • specificity

ASJC Scopus subject areas

  • Statistics and Probability
  • Statistics, Probability and Uncertainty

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