Incorporating a New Summary Statistic into the Min–Max Approach: A Min–Max–Median, Min–Max–IQR Combination of Biomarkers for Maximising the Youden Index

Linearly combining multiple biomarkers is a common practice that can provide a better diagnostic performance. When the number of biomarkers is sufficiently high, a computational burden problem arises. Liu et al. proposed a distribution-free approach (min–max approach) that linearly combines the mini...

Full description

Bibliographic Details
Main Authors: Rocío Aznar-Gimeno, Luis M. Esteban, Gerardo Sanz, Rafael del-Hoyo-Alonso, Ricardo Savirón-Cornudella
Format: Article
Language:English
Published: MDPI AG 2021-10-01
Series:Mathematics
Subjects:
Online Access:https://www.mdpi.com/2227-7390/9/19/2497
_version_ 1827680760851595264
author Rocío Aznar-Gimeno
Luis M. Esteban
Gerardo Sanz
Rafael del-Hoyo-Alonso
Ricardo Savirón-Cornudella
author_facet Rocío Aznar-Gimeno
Luis M. Esteban
Gerardo Sanz
Rafael del-Hoyo-Alonso
Ricardo Savirón-Cornudella
author_sort Rocío Aznar-Gimeno
collection DOAJ
description Linearly combining multiple biomarkers is a common practice that can provide a better diagnostic performance. When the number of biomarkers is sufficiently high, a computational burden problem arises. Liu et al. proposed a distribution-free approach (min–max approach) that linearly combines the minimum and maximum values of the biomarkers, involving only a single coefficient search. However, the combination of minimum and maximum biomarkers alone may not be sufficient in terms of discrimination. In this paper, we propose a new approach that extends that of Liu et al. by incorporating a new summary statistic, specifically, the median or interquartile range (min–max–median and min–max–IQR approaches) in order to find the optimal combination that maximises the Youden index. Although this approach is more computationally intensive than the one proposed by Liu et al, it includes more information and the number of parameters to be estimated remains reasonable. We compare the performance of the proposed approaches (min–max–median and min–max–IQR) with the min–max approach and logistic regression. For this purpose, a wide range of different simulated data scenarios were explored. We also apply the approaches to two real datasets (Duchenne Muscular Dystrophy and Small for Gestational Age).
first_indexed 2024-03-10T06:55:08Z
format Article
id doaj.art-91881105733a4bc4a2649c1d661dc71d
institution Directory Open Access Journal
issn 2227-7390
language English
last_indexed 2024-03-10T06:55:08Z
publishDate 2021-10-01
publisher MDPI AG
record_format Article
series Mathematics
spelling doaj.art-91881105733a4bc4a2649c1d661dc71d2023-11-22T16:31:13ZengMDPI AGMathematics2227-73902021-10-01919249710.3390/math9192497Incorporating a New Summary Statistic into the Min–Max Approach: A Min–Max–Median, Min–Max–IQR Combination of Biomarkers for Maximising the Youden IndexRocío Aznar-Gimeno0Luis M. Esteban1Gerardo Sanz2Rafael del-Hoyo-Alonso3Ricardo Savirón-Cornudella4Department of Big Data and Cognitive Systems, Instituto Tecnológico de Aragón (ITAINNOVA), 50018 Zaragoza, SpainDepartment of Applied Mathematics, Escuela Universitaria Politécnica de La Almunia, Universidad de Zaragoza, La Almunia de Doña Godina, 50100 Zaragoza, SpainDepartment of Statistical Methods and Institute for Biocomputation and Physics of Complex Systems-BIFI, University of Zaragoza, 50009 Zaragoza, SpainDepartment of Big Data and Cognitive Systems, Instituto Tecnológico de Aragón (ITAINNOVA), 50018 Zaragoza, SpainDepartment of Obstetrics and Gynecology, Hospital Clínico San Carlos and Instituto de Investigación Sanitaria San Carlos (IdISSC), Universidad Complutense de Madrid, 28040 Madrid, SpainLinearly combining multiple biomarkers is a common practice that can provide a better diagnostic performance. When the number of biomarkers is sufficiently high, a computational burden problem arises. Liu et al. proposed a distribution-free approach (min–max approach) that linearly combines the minimum and maximum values of the biomarkers, involving only a single coefficient search. However, the combination of minimum and maximum biomarkers alone may not be sufficient in terms of discrimination. In this paper, we propose a new approach that extends that of Liu et al. by incorporating a new summary statistic, specifically, the median or interquartile range (min–max–median and min–max–IQR approaches) in order to find the optimal combination that maximises the Youden index. Although this approach is more computationally intensive than the one proposed by Liu et al, it includes more information and the number of parameters to be estimated remains reasonable. We compare the performance of the proposed approaches (min–max–median and min–max–IQR) with the min–max approach and logistic regression. For this purpose, a wide range of different simulated data scenarios were explored. We also apply the approaches to two real datasets (Duchenne Muscular Dystrophy and Small for Gestational Age).https://www.mdpi.com/2227-7390/9/19/2497linear combinationbiomarkersclassificationYouden indexsummary statisticmin–max approach
spellingShingle Rocío Aznar-Gimeno
Luis M. Esteban
Gerardo Sanz
Rafael del-Hoyo-Alonso
Ricardo Savirón-Cornudella
Incorporating a New Summary Statistic into the Min–Max Approach: A Min–Max–Median, Min–Max–IQR Combination of Biomarkers for Maximising the Youden Index
Mathematics
linear combination
biomarkers
classification
Youden index
summary statistic
min–max approach
title Incorporating a New Summary Statistic into the Min–Max Approach: A Min–Max–Median, Min–Max–IQR Combination of Biomarkers for Maximising the Youden Index
title_full Incorporating a New Summary Statistic into the Min–Max Approach: A Min–Max–Median, Min–Max–IQR Combination of Biomarkers for Maximising the Youden Index
title_fullStr Incorporating a New Summary Statistic into the Min–Max Approach: A Min–Max–Median, Min–Max–IQR Combination of Biomarkers for Maximising the Youden Index
title_full_unstemmed Incorporating a New Summary Statistic into the Min–Max Approach: A Min–Max–Median, Min–Max–IQR Combination of Biomarkers for Maximising the Youden Index
title_short Incorporating a New Summary Statistic into the Min–Max Approach: A Min–Max–Median, Min–Max–IQR Combination of Biomarkers for Maximising the Youden Index
title_sort incorporating a new summary statistic into the min max approach a min max median min max iqr combination of biomarkers for maximising the youden index
topic linear combination
biomarkers
classification
Youden index
summary statistic
min–max approach
url https://www.mdpi.com/2227-7390/9/19/2497
work_keys_str_mv AT rocioaznargimeno incorporatinganewsummarystatisticintotheminmaxapproachaminmaxmedianminmaxiqrcombinationofbiomarkersformaximisingtheyoudenindex
AT luismesteban incorporatinganewsummarystatisticintotheminmaxapproachaminmaxmedianminmaxiqrcombinationofbiomarkersformaximisingtheyoudenindex
AT gerardosanz incorporatinganewsummarystatisticintotheminmaxapproachaminmaxmedianminmaxiqrcombinationofbiomarkersformaximisingtheyoudenindex
AT rafaeldelhoyoalonso incorporatinganewsummarystatisticintotheminmaxapproachaminmaxmedianminmaxiqrcombinationofbiomarkersformaximisingtheyoudenindex
AT ricardosavironcornudella incorporatinganewsummarystatisticintotheminmaxapproachaminmaxmedianminmaxiqrcombinationofbiomarkersformaximisingtheyoudenindex