Integrating the predictiveness of a marker with its performance as a classifier

Margaret S. Pepe, Ziding Feng, Ying Huang, Gary Longton, Ross Prentice, Ian M. Thompson, Yingye Zheng

Research output: Contribution to journalArticlepeer-review

202 Scopus citations


There are two popular statistical approaches to biomarker evaluation. One models the risk of disease (or disease outcome) with, for example, logistic regression. A marker is considered useful if it has a strong effect on risk. The second evaluates classification performance by use of measures such as sensitivity, specificity, predictive values, and receiver operating characteristic curves. There is controversy about which approach is more appropriate. Moreover, the two approaches can give contradictory results on the same data. The authors present a new graphic, the predictiveness curve, which complements the risk modeling approach. It assesses the usefulness of a risk model when applied to the population. Although the predictiveness curve relates to classification performance measures, it also displays essential information about risk that is not displayed by the receiver operating characteristic curve. The authors propose that the predictiveness and classification performance of a marker, displayed together in an integrated plot, provide a comprehensive and cohesive assessment of a risk marker or model. The methods are demonstrated with data on prostate-specific antigen and risk factors from the Prostate Cancer Prevention Trial, 1993-2003.

Original languageEnglish (US)
Pages (from-to)362-368
Number of pages7
JournalAmerican journal of epidemiology
Issue number3
StatePublished - Feb 2008
Externally publishedYes


  • Biological markers
  • Classification analysis
  • Diagnostic tests, routine
  • Epidemiologic methods
  • Predictive value of tests
  • Prostate-specific antigen
  • Risk assessment
  • Risk model

ASJC Scopus subject areas

  • Epidemiology


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