WITHDRAWN: Finding the Optimal Cut Points of Continuous Biomarker Values: A Case Study

• Author(s): E Lin and Lianchun Xiao and Ahmed Kaseb and Manal Hassan and Jeffrey S. Morris
• Keywords: optimal cutpoints ; prognostic factor adjusted ; time-to-event outcomes ; clinical trial ; CLIP ; VCLIP

Abstract

In Hepatocellular cancer (HCC), staging systems are used to provide prognostic information to patients, inform treatment decisions, and stratify patients for clinical trials. Existing staging systemsdo not include information on important angiogenic biomarkers that are central to HCC. We have developed a new staging systemthat adds VEGF to an existing system called the CLIP, which we call V-CLIP. To accomplish this, we use recursive partitioning to identify and validate an optimal cutpoint on the VEGF values for prognosis, using 10-fold cross validation. Finally, we compared the relative prognostic accuracy of the CLIP and V-CLIP staging systems using a C-index analysis. The results of our study show that adding the information of a dichotomized biomarker increases the precision of the existing scoring system, and improves patient stratification and survival time prediction.