Limitations of the Odds Ratio in Gauging the Performance of a Diagnostic, Prognostic, or Screening Marker

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ID: 296054
2004
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Abstract
A marker strongly associated with outcome (or disease) is often assumed to be effective for classifying persons according to their current or future outcome. However, for this assumption to be true, the associated odds ratio must be of a magnitude rarely seen in epidemiologic studies. In this paper, an illustration of the relation between odds ratios and receiver operating characteristic curves shows, for example, that a marker with an odds ratio of as high as 3 is in fact a very poor classification tool. If a marker identifies 10% of controls as positive (false positives) and has an odds ratio of 3, then it will correctly identify only 25% of cases as positive (true positives). The authors illustrate that a single measure of association such as an odds ratio does not meaningfully describe a marker's ability to classify subjects. Appropriate statistical methods for assessing and reporting the classification power of a marker are described. In addition, the serious pitfalls of using more traditional methods based on parameters in logistic regression models are illustrated.
Reference Key
openalex_W2121514893 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors M. S. Pepe
Journal american journal of epidemiology
Year 2004
DOI
10.1093/aje/kwh101
URL
https://doi.org/10.1093/aje/kwh101
Keywords Keywords not found

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