Optimal cut-point and its corresponding youden index to discriminate individuals using pooled blood samples
Optimal cut-point and its corresponding youden index to discriminate individuals using pooled blood samples
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DOI：
10.1097/01.ede.0000147512.81966.ba
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发表时间：
2005-01-01
期刊：
影响因子：
5.4
通讯作者：
Bondell, H
中科院分区：
文献类型：
--
作者：
Schisterman, EF;Perkins, NJ;Bondell, H
成本可能会阻碍对新生物标志物有效性的评估。对较少数量的合并样本进行分析已被证明是一种有用的削减成本的技术。 Youden 指数 (J) 是敏感性 (q) 和特异性 (p) 的函数，是衡量总体诊断有效性的常用指标。更重要的是，J是ROC曲线与对角线或机会线之间的最大垂直距离或差值；当敏感性和特异性同等重要时，它发生在优化生物标志物区分能力的临界点。利用伽玛分布和正态分布的可加性，我们提出了一种估计 Youden 指数和最佳切点的方法，并将其应用扩展到合并样本。我们研究了当只有固定数量的个体可用于测试时合并的效果，并且进行合并是为了节省检测数量。我们通过最佳切点和约登指数估计值的均方根误差的变化来衡量信息损失，并通过模拟研究研究这种损失的程度。总之，池化可以显着降低成本，同时保持估计器的有效性，特别是当池大小不是很大时。
Costs can hamper the evaluation of the effectiveness of new biomarkers. Analysis of smaller numbers of pooled specimens has been shown to be a useful cost-cutting technique. The Youden index (J), a function of sensitivity (q) and specificity (p), is a commonly used measure of overall diagnostic effectiveness. More importantly, J is the maximum vertical distance or difference between the ROC curve and the diagonal or chance line; it occurs at the cut-point that optimizes the biomarker's differentiating ability when equal weight is given to sensitivity and specificity. Using the additive property of the gamma and normal distributions, we present a method to estimate the Youden index and the optimal cut-point, and extend its applications to pooled samples. We study the effect of pooling when only a fixed number of individuals are available for testing, and pooling is carried out to save on the number of assays. We measure loss of information by the change in root mean squared error of the estimates of the optimal cut-point and the Youden index, and we study the extent of this loss via a simulation study. In conclusion, pooling can result in a substantial cost reduction while preserving the effectiveness of estimators, especially when the pool size is not very large.