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Improved Estimation Of Optimal Cut-Off Point Associated With Youden Index Using Ranked Set Sampling, Jingjing Yin, Hani M. Samawi, Daniel Linder

Biostatistics Faculty Publications

A diagnostic cut-off point of a biomarker measurement is needed for classifying a random subject to be either diseased or healthy. However, the cut-off point is usually unknown and needs to be estimated by some optimization criteria. One important criterion is the Youden index, which has been widely adopted in practice. The Youden index, which is defined as the maximum of (sensitivity + specificity −1), directly measures the largest total diagnostic accuracy a biomarker can achieve. Therefore, it is desirable to estimate the optimal cut-off point associated with the Youden index. Sometimes, taking the actual measurements of a biomarker is …