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Estimating the capacity for improvement in risk prediction with a marker

Gu, Wen and Pepe, Margaret S. (2009) Estimating the capacity for improvement in risk prediction with a marker. Biostatistics, 10 (1). pp. 172-186. ISSN 1468-4357

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Consider a set of baseline predictors X to predict a binary outcome D and let Y be a novel marker or predictor. This paper is concerned with evaluating the performance of the augmented risk model P(D = 1|Y,X) compared with the baseline model P(D = 1|X). The diagnostic likelihood ratio, DLRX(y), quantifies the change in risk obtained with knowledge of Y = y for a subject with baseline risk factors X. The notion is commonly used in clinical medicine to quantify the increment in risk prediction due to Y . It is contrasted here with the notion of covariate adjusted effect of Y in the augmented risk model. We also propose methods for making inference about DLRX(y). Case-control study designs are accommodated. The methods provide a mechanism to investigate if the predictive information in Y varies with baseline covariates. In addition, we show that when combined with a baseline risk model and information about the population distribution of Y given X, covariate specific predictiveness curves can be estimated. These curves are useful to an individual in deciding if ascertainment of Y is likely to be informative or not for him. We illustrate with data from two studies: one is a study of the performance of hearing screening tests for infants; the other concerns the value of serum creatinine in diagnosing renal artery stenosis.

Item Type: Article or Abstract
Additional Information: This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Biostatistics following peer review. The definitive publisher-authenticated version Biostatistics. 2009 Jan;10(1):172-86 is available online at:
DOI: 10.1093/biostatistics/kxn025
PubMed ID: 18714084
PMCID: PMC2639345
Grant Numbers: R01 GM054438-12, U01 CA086368-09
Keywords or MeSH Headings: Biological Markers/*analysis; Biometry/methods; Creatinine/blood; Diagnostic Techniques and Procedures/standards; Female; Hearing Tests/methods/statistics & numerical data; Humans; Infant; *Likelihood Functions; Logistic Models; Male; Predictive Value of Tests; Reference Values; Renal Artery Obstruction/blood/epidemiology/physiopathology; Retrospective Studies; Risk Assessment/*methods; Risk Factors
Subjects: Research Methodologies > Research design
Research Methodologies > Epidemiology > Risk assessment
Research Methodologies > Mathematics and statistics
Depositing User: Library Staff
Date Deposited: 25 Sep 2008 18:12
Last Modified: 14 Feb 2012 14:42

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