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Combining Multiple Diagnostic Tests with NonParametric Transformation Models for Classifying Censored Event Times

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Recent advancement in technology promises to yield a multitude of tests for disease diagnosis and prognosis. When there are multiple sources of information available, it is often of interest to construct a composite score that can provide better classification accuracy than an individual test. In this paper we consider robust procedures for optimally combining tests when test results are measured prior to disease onset and the disease status evolves over time. The most commonly used approach for combining tests to detect subsequent disease status is to fit a proportional hazards model (Cox, 1972) and use the estimated risk score. However, simulation studies suggested that such a risk score may have poor accuracy when the proportional hazards assumption fails. We propose the use of a nonparametric transformation model (Han, 1987) as a working model to derive an optimal composite score with theoretical justification. We demonstrate that the proposed score is the optimal score when the model holds and is optimal ``on average'' among linear scores even if the model fails. Time-dependent sensitivity, specificity and ROC functions are used to quantify the accuracy of the resulting composite score. We provide consistent and asymptotically Gaussian estimators of these accuracy measures. A simple model-free resampling procedure is proposed to obtain all consistent variance estimators. We illustrate the new proposals with simulation studies and an analysis of a breast cancer gene-expression dataset.

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What
Meeting
When
2005-09-28 from 12:00 to 13:00
Where
FHCRC Arnold Building M1-A307
Name
Helen Pagal
Contact Email
hpagal@scharp.org
Contact Phone
206.667.6099
Created by bmecham
Last modified 2005-09-22 12:21 PM
 

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