A modified area under the ROC curve and its application to marker selection and classification

The area under the ROC curve (AUC) can be interpreted as the probability that the classification scores of a diseased subject is larger than that of a non-diseased subject for a randomly sampled pair of subjects. From the perspective of classification, we want to find a way to separate two groups as distinctly as possible via AUC. When the difference of the scores of a marker is small, its impact on classification is less important. Thus, a new diagnostic/classification measure based on a modified area under the ROC curve (mAUC) is proposed, which is defined as a weighted sum of two AUCs, where the AUC with the smaller difference is assigned a lower weight, and vice versa. Using mAUC is robust in the sense that mAUC gets larger as AUC gets larger as long as they are not equal. Moreover, in many diagnostic situations, only a specific range of specificity is of interest. Under normal distributions, we show that if the AUCs of two markers are within similar ranges, the larger mAUC implies the larger partial AUC for a given specificity. This property of mAUC will help to identify the marker with the higher partial AUC, even when the AUCs are similar. Two nonparametric estimates of an mAUC and their variances are given. We also suggest the use of mAUC as the objective function for classification, and the use of the gradient Lasso algorithm for classifier construction and marker selection. Application to simulation datasets and real microarray gene expression datasets show that our method finds a linear classifier with a higher ROC curve than some other existing linear classifiers, especially in the range of low false positive rates.     

Consistency of non parametric estimators of the area under the ROC curve

ABSTRACT

The area under the receiver operating characteristic (ROC) curve is a popular summary index that measures the accuracy of a continuous-scale diagnostic test to measure its accuracy. Under certain conditions on estimators of distribution functions, we prove a theorem on strong consistency of the non parametric “plugin” estimators of the area under the ROC curve. Based on this theorem, we construct some new “plugin” consistent estimators. The performance of the non parametric estimators considered is illustrated numerically and the estimators are compared in terms of bias, variance, and mean square error.     

Non‐parametric interval estimation for the partial area under the ROC curve

Accurate diagnosis of disease is a critical part of health care. New diagnostic and screening tests must be evaluated based on their abilities to discriminate diseased conditions from non‐diseased conditions. For a continuous‐scale diagnostic test, a popular summary index of the receiver operating characteristic (ROC) curve is the area under the curve (AUC). However, when our focus is on a certain region of false positive rates, we often use the partial AUC instead. In this paper we have derived the asymptotic normal distribution for the non‐parametric estimator of the partial AUC with an explicit variance formula. The empirical likelihood (EL) ratio for the partial AUC is defined and it is shown that its limiting distribution is a scaled chi‐square distribution. Hybrid bootstrap and EL confidence intervals for the partial AUC are proposed by using the newly developed EL theory. We also conduct extensive simulation studies to compare the relative performance of the proposed intervals and existing intervals for the partial AUC. A real example is used to illustrate the application of the recommended intervals. The Canadian Journal of Statistics 39: 17–33; 2011 © 2011 Statistical Society of Canada     

Bounding sample size projections for the area under a ROC curve

Studies of diagnostic tests are often designed with the goal of estimating the area under the receiver operating characteristic curve (AUC) because the AUC is a natural summary of a test's overall diagnostic ability. However, sample size projections dealing with AUCs are very sensitive to assumptions about the variance of the empirical AUC estimator, which depends on two correlation parameters. While these correlation parameters can be estimated from the available data, in practice it is hard to find reliable estimates before the study is conducted. Here we derive achievable bounds on the projected sample size that are free of these two correlation parameters. The lower bound is the smallest sample size that would yield the desired level of precision for some model, while the upper bound is the smallest sample size that would yield the desired level of precision for all models. These bounds are important reference points when designing a single or multi-arm study; they are the absolute minimum and maximum sample size that would ever be required. When the study design includes multiple readers or interpreters of the test, we derive bounds pertaining to the average reader AUC and the ‘pooled’ or overall AUC for the population of readers. These upper bounds for multireader studies are not too conservative when several readers are involved.     

Nonparametric estimation of the ROC curve for length-biased and right-censored data

Abstract

ROC curve is a fundamental evaluation tool in medical researches and survival analysis. The estimation of ROC curve has been studied extensively with complete data and right-censored survival data. However, these methods are not suitable to analyze the length-biased and right-censored data. Since this kind of data includes the auxiliary information that truncation time and residual time share the same distribution, the two new estimators for the ROC curve are proposed by taking into account this auxiliary information to improve estimation efficiency. Numerical simulation studies with different assumed cases and real data analysis are conducted.     

Estimation of the area under ROC curve with censored data

The area under the receiver operating characteristic curve is the most commonly used summary measure of diagnostic accuracy for a continuous-scale diagnostic test. In this paper, we develop methods to estimate the area under the curve (AUC) with censored data. Based on two different integration representations of this parameter, two nonparametric estimators are defined by the “plug in” method. Both the proposed estimators are shown to be asymptotically normal based on counting process and martingale theory. A simulation study is conducted to evaluate the performances of the proposed estimators.     

Optimal nonparametric estimator of the area under ROC curve based on clustered data

Abstract

In diagnostic trials, clustered data are obtained when several subunits of the same patient are observed. Intracluster correlations need to be taken into account when analyzing such clustered data. A nonparametric method has been proposed by Obuchowski (1997 Obuchowski, N. A. 1997. Nonparametric analysis of clustered ROC curve data. Biometrics 53 (2):567–78.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) to estimate the Receiver Operating Characteristic curve area (AUC) for such clustered data. However, Obuchowski’s estimator is not efficient as it gives equal weight to all pairwise rankings within and between cluster. In this paper, we propose a more efficient nonparametric AUC estimator with two sets of optimal weights. Simulation results show that the loss of efficiency of Obuchowski’s estimator for a single AUC or the AUC difference can be substantial when there is a moderate intracluster test correlation and the cluster size is large. The efficiency gain of our weighted AUC estimator for a single AUC or the AUC difference is further illustrated using the data from a study of screening tests for neonatal hearing.     

Nonparametric Predictive Inference for diagnostic accuracy

Measuring the accuracy of diagnostic tests is crucial in many application areas including medicine and health care. Good methods for determining diagnostic accuracy provide useful guidance on selection of patient treatment, and the ability to compare different diagnostic tests has a direct impact on quality of care. In this paper Nonparametric Predictive Inference (NPI) methods for accuracy of diagnostic tests with continuous test results are presented and discussed. For such tests, Receiver Operating Characteristic (ROC) curves have become popular tools for describing the performance of diagnostic tests. We present the NPI approach to ROC curves, and some important summaries of these curves. As NPI does not aim at inference for an entire population but instead explicitly considers a future observation, this provides an attractive alternative to standard methods. We show how NPI can be used to compare two continuous diagnostic tests.     

Confidence intervals and bands for the binormal ROC curve revisited

Two types of confidence intervals (CIs) and confidence bands (CBs) for the receiver operating characteristic (ROC) curve are studied: pointwise CIs and simultaneous CBs. An optimized version of the pointwise CI with the shortest width is developed. A new ellipse-envelope simultaneous CB for the ROC curve is suggested as an adaptation of the Working-Hotelling-type CB implemented in a paper by Ma and Hall (1993). Statistical simulations show that our ellipse-envelope CB covers the true ROC curve with a probability close to nominal while the coverage probability of the Ma and Hall CB is significantly smaller. Simulations also show that our CI for the area under the ROC curve is close to nominal while the coverage probability of the CI suggested by Hanley and McNail (1982) uniformly overestimates the nominal value. Two examples illustrate our simultaneous ROC bands: radiation dose estimation from time to vomiting and discrimination of breast cancer from benign abnormalities using electrical impedance measurements.     

Factors effecting the model performance measures area under the ROC curve,net reclassification improvement and integrated discrimination improvement

ABSTRACT

The aim of this study is to investigate the impact of correlation structure, prevalence and effect size on the risk prediction model by using the change in the area under the receiver operating characteristic curve (ΔAUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI). In simulation study, the dataset is generated under different correlation structures, prevalences and effect sizes. We verify the simulation results with the real-data application. In conclusion, the correlation structure between the variables should be taken into account while composing a multivariable model. Negative correlation structure between independent variables is more beneficial while constructing a model.     

A Framework for Random-Effects ROC Analysis: Biases with the Bootstrap and Other Variance Estimators

In this article, we analyze the three-way bootstrap estimate of the variance of the reader-averaged nonparametric area under the receiver operating characteristic (ROC) curve. The setting for this work is medical imaging, and the experimental design involves sampling from three distributions: a set of normal and diseased cases (patients), and a set of readers (doctors). The experiment we consider is fully crossed in that each reader reads each case. A reading generates a score that indicates the reader's level of suspicion that the patient is diseased. The distribution of scores for the normal patients is compared to the distribution of scores for the diseased patients via an ROC curve, and the area under the ROC curve (AUC) summarizes the reader's diagnostic ability to separate the normal patients from the diseased ones. We find that the bootstrap estimate of the variance of the reader-averaged AUC is biased, and we represent this bias in terms of moments of success outcomes. This representation helps unify and improve several current methods for multi-reader multi-case (MRMC) ROC analysis.     

Optimal Composite Markers for Time‐Dependent Receiver Operating Characteristic Curves with Censored Survival Data

Abstract. To increase the predictive abilities of several plasma biomarkers on the coronary artery disease (CAD)‐related vital statuses over time, our research interest mainly focuses on seeking combinations of these biomarkers with the highest time‐dependent receiver operating characteristic curves. An extended generalized linear model (EGLM) with time‐varying coefficients and an unknown bivariate link function is used to characterize the conditional distribution of time to CAD‐related death. Based on censored survival data, two non‐parametric procedures are proposed to estimate the optimal composite markers, linear predictors in the EGLM model. Estimation methods for the classification accuracies of the optimal composite markers are also proposed. In the article we establish theoretical results of the estimators and examine the corresponding finite‐sample properties through a series of simulations with different sample sizes, censoring rates and censoring mechanisms. Our optimization procedures and estimators are further shown to be useful through an application to a prospective cohort study of patients undergoing angiography.     

Criteria for reporting noncompartmental estimates of half‐life and area under the curve extrapolated to infinity

Various criteria have been proposed for determining the reliability of noncompartmental pharmacokinetic estimates of the terminal disposition phase half‐life (t_1/2) and the extrapolated area under the curve (AUC_extrap). This simulation study assessed the performance of two frequently used reportability rules: the terminal disposition phase regression adjusted‐r² classification rule and the regression data point time span classification rule. Using simulated data, these rules were assessed in relation to the magnitude of the variability in the terminal disposition phase slope, the length of the terminal disposition phase captured in the concentration‐time profile (data span), the number of data points present in the terminal disposition phase, and the type and level of variability in concentration measurement. The accuracy of estimating t_1/2 was satisfactory for data spans of 1.5 and longer, given low measurement variability; and for spans of 2.5 and longer, given high measurement variability. Satisfactory accuracy in estimating AUC_extrap was only achieved with low measurement variability and spans of 2.5 and longer. Neither of the classification rules improved the identification of accurate t_1/2 and AUC_extrap estimates. Based on the findings of this study, a strategy is proposed for determining the reportability of estimates of t_1/2 and area under the curve extrapolated to infinity.