Regression Analysis of Diagnostic Accuracy of Biomarkers with a Continuous Gold Standard
*Aiyi Liu, National Institutes of Health(NICHD)
Keywords: Biomarkers, Diagnostic accuracy, Covariate adjustment, Regression analysis
Receiver operating characteristic (ROC) curve is a popular tool to describe and compare the diagnostic accuracy of biomarkers when a binary-scale gold standard is available. There are, however, many examples of diagnostic tests whose gold standards are continuous. Hence, several extensions are proposed to evaluate the diagnostic potential of biomarkers when the gold standard is continuous-scale. Moreover, in evaluating these biomarkers, it is often necessary to consider the effects of covariates on the diagnostic accuracy of the biomarker of interest. Covariates may include subject characteristics, expertise of the test operator, test procedures, or aspects of specimen handling. Applying the covariates adjustment to the case that the gold standard is continuous is challenging and has not been addressed in the literature. To fill the gap, we propose a general regression framework to account for the covariates effect on diagnostic accuracy.