Combining binary and continuous biomarkers by maximizing the area under the receiver operating characteristic curve

Abstract

In any clinical case, a decision is made with the maximum possible accuracy. To achieve such accuracy, in the presence of multiple diagnostic tests or biomarkers, biomarker combinations aim to achieve maximum accuracy. As existing biomarker combination methods combine only continuous biomarkers, therefore in this study biomarker combination for binary biomarkers was created by suggesting an approach using Youden's J statistic for combining binary biomarkers. The proposed approach will facilitate binary and continuous biomarker combinations. A simulation study was conducted to compare the performance of our proposed combination approach according to different sample sizes. Both in the analysis of real data and the simulation studies for different samples, the proposed approach has been shown to yield favorable results and higher area under the curve.