Adjusting for covariates in studies of diagnostic, screening, or prognostic markers: an old concept in a new setting

The concept of covariate adjustment is well established in therapeutic and etiologic studies. However, it has received little attention in the growing area of medical research devoted to the development of markers for disease diagnosis, screening, or prognosis, where classification accuracy, rather...

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Bibliographic Details
Published in:American journal of epidemiology Vol. 168; no. 1; p. 89
Main Authors: Janes, Holly, Pepe, Margaret S
Format: Journal Article
Language:English
Published: United States 01.07.2008
Subjects:
Aged
Biomarkers, Tumor - blood
Epidemiologic Methods
Humans
Male
Middle Aged
Prostate-Specific Antigen - blood
Prostatic Neoplasms - diagnosis
Randomized Controlled Trials as Topic
ROC Curve
Sensitivity and Specificity
ISSN:1476-6256, 1476-6256
Online Access:Get more information
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Summary:The concept of covariate adjustment is well established in therapeutic and etiologic studies. However, it has received little attention in the growing area of medical research devoted to the development of markers for disease diagnosis, screening, or prognosis, where classification accuracy, rather than association, is of primary interest. In this paper, the authors demonstrate the need for covariate adjustment in studies of classification accuracy, discuss methods for adjusting for covariates, and distinguish covariate adjustment from several other related, but fundamentally different, uses for covariates. They draw analogies and contrasts throughout with studies of association.
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ISSN:1476-6256
1476-6256
DOI:10.1093/aje/kwn099