Grant Number:	5R01CA207220-03 Interpret this number
Primary Investigator:	Heller, Glenn
Organization:	Sloan-Kettering Inst Can Research
Project Title:	Inferential Methods to Assess the Incremental Value of New Biomarkers in Risk Classification Models
Fiscal Year:	2019

Abstract This proposal aims to develop statistical methods to evaluate improvement in risk classification measures due to the inclusion of new biomarkers. Risk classification modeling has a direct impact on patient treatment and health. These models are used to identify the need for diagnostic testing in the general population, or the type of treatment to be administered in a specified patient population. The most common risk classification improvement measures include the difference in the area under the receiver operating characteristic curve, the net reclassification index, the integrated discrimination improvement, and the difference in sensitivity and specificity. The new statistical methods will provide a metric to decide whether a change in patient risk, stemming from the evaluation of new biomarkers, is random variation or a true improvement in the accuracy of a risk classification model. The metric is defined through asymptotic distribution theory within a nested models framework. Methods to assess improvement in the accuracy of risk models are not well-developed, with current methods relying on classical hypothesis tests of association. These tests may lead to dissonance, since the results of parametric association statistics may not align with the nonparametric risk improvement statistics used in the models being evaluated. The objective of this grant proposal is to develop a coherent statistical inferential strategy that directly measures the incremental value of new biomarkers in risk classification models with binary and survival endpoints. The aims of the proposal are: 1) To develop inferential methods for the difference in concordance probability measures from nested proportional hazards models with a survival endpoint.2) To develop inferential methods for the incremental value of Net Reclassification Index (NRI) and Integrated Discrimination Improvement (IDI) with binary and survival regression models. 3) To develop inferential methods for the incremental value of sensitivity and specificity with binary and survival regression models. Measures of risk classification improvement impact medical decision making. The statistical evaluation of the incremental benefit of a new panel of markers, in relation to clinical measures and laboratory tests that are acquired in the course of routine clinical practice, will play a role in the level of confidence physicians and medical researchers have in updating their medical intervention algorithm.




A Modified Net Reclassification Improvement Statistic.
Authors: Heller G. .
Source: Journal Of Statistical Planning And Inference, 2023 Dec; 227, p. 18-33.
EPub date: 2023-03-11 00:00:00.0.
PMID: 37035267
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Concordance probability as a meaningful contrast across disparate survival times.
Authors: Devlin S.M. , Heller G. .
Source: Statistical Methods In Medical Research, 2021 03; 30(3), p. 816-825.
EPub date: 2020-12-09 00:00:00.0.
PMID: 33297851
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The added value of new covariates to the brier score in cox survival models.
Authors: Heller G. .
Source: Lifetime Data Analysis, 2021 Jan; 27(1), p. 1-14.
EPub date: 2020-10-22 00:00:00.0.
PMID: 33089436
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Measuring the temporal prognostic utility of a baseline risk score.
Authors: Devlin S.M. , Gönen M. , Heller G. .
Source: Lifetime Data Analysis, 2020-07-24 00:00:00.0; , .
EPub date: 2020-07-24 00:00:00.0.
PMID: 32710191
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Assessment of the Validity of Nuclear-Localized Androgen Receptor Splice Variant 7 in Circulating Tumor Cells as a Predictive Biomarker for Castration-Resistant Prostate Cancer.
Authors: Scher H.I. , Graf R.P. , Schreiber N.A. , Jayaram A. , Winquist E. , McLaughlin B. , Lu D. , Fleisher M. , Orr S. , Lowes L. , et al. .
Source: Jama Oncology, 2018-09-01 00:00:00.0; 4(9), p. 1179-1186.
PMID: 29955787
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Reply to C. Ren et al.
Authors: Heller G. , McCormack R. , Kheoh T. , Molina A. , Smith M.R. , Dreicer R. , Saad F. , de Wit R. , Aftab D.T. , Hirmand M. , et al. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2018-08-01 00:00:00.0; 36(22), p. 2354-2356.
EPub date: 2018-06-12 00:00:00.0.
PMID: 29894273
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Circulating Tumor Cell Number as a Response Measure of Prolonged Survival for Metastatic Castration-Resistant Prostate Cancer: A Comparison With Prostate-Specific Antigen Across Five Randomized Phase III Clinical Trials.
Authors: Heller G. , McCormack R. , Kheoh T. , Molina A. , Smith M.R. , Dreicer R. , Saad F. , de Wit R. , Aftab D.T. , Hirmand M. , et al. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2018-02-20 00:00:00.0; 36(6), p. 572-580.
EPub date: 2017-12-22 00:00:00.0.
PMID: 29272162
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