A0796
Title: On optimal biomarker cutoffs accounting for misclassification costs in diagnostic trilemmas
Authors: Leonidas Bantis - University of Kansas Medical Center (United States) [presenting]
John Tsimikas - University of the Aegean (Greece)
Abstract: The ROC surface is an appropriate tool for assessing the overall accuracy of a marker employed under trichotomous settings. A decision/classification rule is often based on the so-called Youden index and its three-dimensional generalization. However, both the clinical and the statistical literature have not paid the necessary attention to the underlying false classification (FC) rates that are of equal or even greater importance. We provide a framework to make inferences around all classification rates as well as relevant comparisons. We also accommodate the underlying misclassification costs associated with the false classification rates. We explore the trinormal model, flexible models based on power transformations, and robust non-parametric alternatives. We evaluate our approaches through extensive simulations and illustrate them using data from a study that involves patients with pancreatic cancer.
