Combining Biomarkers by Maximizing the True Positive Rate for a Fixed False Positive Rate

• Activity Number: 126 - Diagnostics, Classification, and Agreement
• Type: Contributed
• Date/Time: Monday, July 31, 2017 : 8:30 AM to 10:20 AM
• Sponsor: Section on Medical Devices and Diagnostics
• Author(s): Allison Meisner* and Marco Carone and Margaret Pepe and Katie Kerr
• Companies: University of Washington and University of Washington Department of Biostatistics and Fred Hutchinson Cancer Research Center and University of Washington Department of Biostatistics
• Keywords: Biomarker ; Combination ; Sensitivity ; True positive rate

Abstract

Biomarkers abound in many areas of clinical research, and often investigators are interested in combining them for diagnosis, prognosis, and screening. In many applications, the true positive rate for a biomarker combination at a prespecified, clinically acceptable false positive rate is the most relevant measure of predictive capacity. We propose a distribution-free method for constructing biomarker combinations by maximizing the true positive rate while constraining the false positive rate. Theoretical results demonstrate good operating characteristics for the resulting combination. In simulations, the biomarker combination provided by our method demonstrated better operating characteristics in a variety of scenarios when compared with more traditional methods for constructing combinations.