Receiver Operating Characteristic Curve Inference from a Sample with a Limit of Detection
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TLDR
The authors show that replacement values below the limit of detection, including those suggested, result in the same biased area under the curve when properly accounted for, but they also provide guidance on the usefulness of these values in limited situations.Abstract:
The receiver operating characteristic curve is a commonly used tool for evaluating biomarker usefulness in clinical diagnosis of disease. Frequently, biomarkers being assessed have immeasurable or unreportable samples below some limit of detection. Ignoring observations below the limit of detection leads to negatively biased estimates of the area under the curve. Several correction methods are suggested in the areas of mean estimation and testing but nothing regarding the receiver operating characteristic curve or its summary measures. In this paper, the authors show that replacement values below the limit of detection, including those suggested, result in the same biased area under the curve when properly accounted for, but they also provide guidance on the usefulness of these values in limited situations. The authors demonstrate maximum likelihood techniques leading to asymptotically unbiased estimators of the area under the curve for both normally and gamma distributed biomarker levels. Confidence intervals are proposed, the coverage probability of which is scrutinized by simulation study. An example using polychlorinated biphenyl levels to classify women with and without endometriosis illustrates the potential benefits of these methods.read more
Citations
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Maximum likelihood ratio tests for comparing the discriminatory ability of biomarkers subject to limit of detection.
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References
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Journal ArticleDOI
Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine.
Mark H. Zweig,Gregory Campbell +1 more
TL;DR: Receiver-operating characteristic (ROC) plots provide a pure index of accuracy by demonstrating the limits of a test's ability to discriminate between alternative states of health over the complete spectrum of operating conditions.
Journal ArticleDOI
Estimation of Average Concentration in the Presence of Nondetectable Values
TL;DR: In this article, the average concentration of a particular contaminant during some period of time, a certain proportion of the collected samples is often reported to be below the limit of detection.
BookDOI
Statistical Methods in Diagnostic Medicine
TL;DR: This book discusses the design of Diagnostic Accuracy Studies, the construction of a Smooth ROC Curve, and how to select a Sampling Plan for Readers based on Sensitivity and Specificity.