Inference for the difference in the area under the ROC curve derived from nested binary regression models

The area under the curve (AUC) statistic is a common measure of model performance in a binary regression model. Nested models are used to ascertain whether the AUC statistic increases when new factors enter the model. The regression coefficient estimates used in the AUC statistics are computed using the maximum rank correlation methodology. Typically, inference for the difference in AUC statistics from nested models is derived under asymptotic normality. In this work, it is demonstrated that the asymptotic normality is true only when at least one of the new factors is associated with the binary outcome. When none of the new factors are associated with the binary outcome, the asymptotic distribution for the difference in AUC statistics is a linear combination of chi-square random variables. Further, when at least one new factor is associated with the outcome and the population difference is small, a variance stabilizing reparameterization improves the asymptotic normality of the AUC difference statistic. A confidence interval using this reparameterization is developed and simulations are generated to determine their coverage properties. The derived confidence interval provides information on the magnitude of the added value of new factors and enables investigators to weigh the size of the improvement against potential costs associated with the new factors. A pancreatic cancer data example is used to illustrate this approach.