Accommodating covariates in receiver operating characteristic analysis

A popular topic in medical research today is the development of markers to classify subjects as diseased or disease free, as high or low risk, or in terms of treatment response or another future event.

The pooled ROC curve describes the ability of the marker to discriminate between cases and controls, and it includes the portion of discriminatory accuracy due to the covariate.Finally, we provide practical recommendations for determining when and how to adjust for covariates, and we include links to software that can be used to implement these techniques.The classification accuracy of a continuous marker, , is its ability to distinguish between two groups defined by a binary outcome.The performances of the 2.5 thresholding rule are indicated.The need for covariate adjustment is much more general, however.

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