Estimation of the Youden index and its associated cutoff point
Estimation of the Youden index and its associated cutoff point
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DOI：
10.1002/bimj.200410135
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发表时间：
2005-08-01
影响因子：
1.7
通讯作者：
Reiser, B
中科院分区：
文献类型：
--
作者：
Fluss, R;Faraggi, D;Reiser, B
约登指数是一种常用的ROC(接收器工作特性)曲线的汇总指标。它既能测量诊断标记物的有效性，又能为标记物选择最佳阈值(截止点)。在本文中，我们比较了尤登指数及其相关截止点的几种估计方法。它们基于(1)正态假设；(2)正态转换；(3)经验分布函数；(4)核平滑。通过大量的仿真研究，比较了各种情况下的偏差和均方根误差。我们发现，最常用的实证方法总体表现最差。在Youden指数的估计中，除非能够很好地对数据进行变换以达到正态分布，否则核函数通常是最好的，而在最佳阈值的估计中，结果的变化性较大。
The Youden Index is a frequently used summary measure of the ROC (Receiver Operating Characteristic) curve. It both, measures the effectiveness of a diagnostic marker and enables the selection of an optimal threshold value (cutoff point) for the marker. In this paper we compare several estimation procedures for the Youden Index and its associated cutoff point. These are based on (1) normal assumptions; (2) transformations to normality; (3) the empirical distribution function; (4) kernel smoothing. These are compared in terms of bias and root mean square error in a large variety of scenarios by means of an extensive simulation study. We find that the empirical method which is the most commonly used has the overall worst performance. In the estimation of the Youden Index the kernel is generally the best unless the data can be well transformed to achieve normality whereas in estimation of the optimal threshold value results are more variable.