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R을 이용한 결과 변수에 따른 최적의 Cut-off Point 결정

Determining the Optimal Cut-off Point According to the Outcome Variables Using R

  • 양주연 (연세대학교 의과대학 의학통계지원실) ;
  • 이혜선 (연세대학교 의과대학 의학통계지원실)
  • Juyeon Yang (Biostatistics Collaboration Unit, Yonsei University College of Medicine) ;
  • Hye Sun Lee (Biostatistics Collaboration Unit, Yonsei University College of Medicine)
  • 투고 : 2022.10.28
  • 심사 : 2022.11.12
  • 발행 : 2022.12.01

초록

Clinical research ultimately aimed to promptly diagnose and prevent diseases through precise biomarker development. Finding the optimal cut-off point of a regularly measured biomarker can help its interpretation and ultimately help in disease investigation and diagnosis, more specifically in determining the presence of diseases. Therefore, this study aimed to use the characteristics of outcome variables in clinical research to explain how to determine the optimal cutoff point. The outcome variables can be divided into dichotomous, ordinal, and survival types. The optimal cut-off point can be determined by finding points that maximize the Youden index, extended Youden index, and log-rank statistics. This study will enable clinical researchers to accurately determine the optimal cut-off points for regularly measured biomarkers, thereby enabling prompt disease diagnosis for effective treatment.

키워드

참고문헌

  1. Schisterman EF, Perkins NJ, Liu A, Bondell H. Optimal cut-point and its corresponding Youden Index to discriminate individuals using pooled blood samples. Epidemiology 2005;16:73-81. https://doi.org/10.1097/01.ede.0000147512.81966.ba
  2. Ruopp MD, Perkins NJ, Whitcomb BW, Schisterman EF. Youden Index and optimal cut-point estimated from observations affected by a lower limit of detection. Biom J 2008;50:419-430. https://doi.org/10.1002/bimj.200710415
  3. Fluss R, Faraggi D, Reiser B. Estimation of the Youden Index and its associated cutoff point. Biom J 2005;47:458-472. https://doi.org/10.1002/bimj.200410135
  4. Robin X, Turck N, Hainard A, et al. pROC: an open-source package for R and S+ to analyze and compare ROC curves. BMC Bioinformatics 2011;12:77. https://doi.org/10.1186/1471-2105-12-77
  5. Shin YG, Yoo J, Kwon HJ, et al. Histogram and gray level co-occurrence matrix on gray-scale ultrasound images for diagnosing lymphocytic thyroiditis. Comput Biol Med 2016;75:257-266. https://doi.org/10.1016/j.compbiomed.2016.06.014
  6. Nahm FS. Receiver operating characteristic curve: overview and practical use for clinicians. Korean J Anesthesiol 2022;75:25-36. https://doi.org/10.4097/kja.21209
  7. Johnson NP. Advantages to transforming the receiver operating characteristic (ROC) curve into likelihood ratio co-ordinates. Stat Med 2004;23:2257-2266. https://doi.org/10.1002/sim.1835
  8. Xiong C, van Belle G, Miller JP, Morris JC. Measuring and estimating diagnostic accuracy when there are three ordinal diagnostic groups. Stat Med 2006;25:1251-1273. https://doi.org/10.1002/sim.2433
  9. Luo J, Xiong C. Youden Index and associated cut-points for three ordinal diagnostic groups. Commun Stat Simul Comput 2013;42:1213-1234. https://doi.org/10.1080/03610918.2012.661906
  10. Luo J, Xiong C. DiagTest3Grp: an R package for analyzing diagnostic tests with three ordinal groups. J Stat Softw 2012;51:1-24. https://doi.org/10.18637/jss.v051.i03
  11. Lausen B, Schumacher M. Maximally selected rank statistics. Biometrics 1992;48:73-85. https://doi.org/10.2307/2532740
  12. Hothorn T, Lausen B. On the exact distribution of maximally selected rank statistics. Comput Stat Data Anal 2003;43:121-137. https://doi.org/10.1016/S0167-9473(02)00225-6
  13. Bland JM, Altman DG. The logrank test. BMJ 2004;328:1073. https://doi.org/10.1136/bmj.328.7447.1073
  14. Hothorn T, Hothorn MT, Suggests TH. Package 'maxstat'. 2017. https://cran.rproject.org/web/packages/maxstat/maxstat.pdf. (accessed October 19, 2022).
  15. Modhukur V, Iljasenko T, Metsalu T, Lokk K, LaiskPodar T, Vilo J. MethSurv: a web tool to perform multivariable survival analysis using DNA methylation data. Epigenomics 2018;10:277-288. https://doi.org/10.2217/epi-2017-0118
  16. Hothorn T, Hornik K, Strobl C, Zeileis A, Hothorn MT. Package 'party'. Packag Ref Man Party Version 0.9-998 2015;16:37.