Reflection on modern methods: Revisiting the area under the ROC Curve.

Abstract:

:The area under the receiver operating characteristic (ROC) curve (AUC) is commonly used for assessing the discriminative ability of prediction models even though the measure is criticized for being clinically irrelevant and lacking an intuitive interpretation. Every tutorial explains how the coordinates of the ROC curve are obtained from the risk distributions of diseased and non-diseased individuals, but it has not become common sense that therewith the ROC plot is just another way of presenting these risk distributions. We show how the ROC curve is an alternative way to present risk distributions of diseased and non-diseased individuals and how the shape of the ROC curve informs about the overlap of the risk distributions. For example, ROC curves are rounded when the prediction model included variables with similar effect on disease risk and have an angle when, for example, one binary risk factor has a stronger effect; and ROC curves are stepped rather than smooth when the sample size or incidence is low, when the prediction model is based on a relatively small set of categorical predictors. This alternative perspective on the ROC plot invalidates most purported limitations of the AUC and attributes others to the underlying risk distributions. AUC is a measure of the discriminative ability of prediction models. The assessment of prediction models should be supplemented with other metrics to assess their clinical utility.

journal_name

Int J Epidemiol

authors

Janssens ACJW,Martens FK

doi

10.1093/ije/dyz274

subject

Has Abstract

pub_date

2020-08-01 00:00:00

pages

1397-1403

issue

4

eissn

0300-5771

issn

1464-3685

pii

5714095

journal_volume

49

pub_type

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