title: Adjusting the generalized ROC curve for covariates.
abstract: Receiver operating characteristic (ROC) curves and in particular the area under the curve (AUC), are widely used to examine the effectiveness of diagnostic markers. Diagnostic markers and their corresponding ROC curves can be strongly influenced by covariate variables. When several diagnostic markers are available, they can be combined by a best linear combination such that the area under the ROC curve of the combination is maximized among all possible linear combinations. In this paper we discuss covariate effects on this linear combination assuming that the multiple markers, possibly transformed, follow a multivariate normal distribution. The ROC curve of this linear combination when markers are adjusted for covariates is estimated and approximate confidence intervals for the corresponding AUC are derived. An example of two biomarkers of coronary heart disease for which covariate information on age and gender is available is used to illustrate this methodology.
authors.affiliation: Division of Epidemiology, Statistics and Prevention, NICHD, NIH, USA.
authors.forename: Enrique F
authors.initials: EF
authors.lastname: Schisterman
authors.forename: David
authors.initials: D
authors.lastname: Faraggi
authors.forename: Benjamin
authors.initials: B
authors.lastname: Reiser
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D015415:Biomarkers / Q000032:analysis; D002839:Chromans / Q000032:analysis; D003327:Coronary Disease / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012372:ROC Curve; D012044:Regression Analysis; D017392:Thiobarbituric Acid Reactive Substances / Q000032:analysis
chemical_list: D015415:Biomarkers; D002839:Chromans; D017392:Thiobarbituric Acid Reactive Substances; C010643:6-hydroxy-2,5,7,8-tetramethylchroman-2-carboxylic acid