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Selecting Multiple Biomarker Subsets with Similarly Effective Binary Classification Performances
Published on: October 11, 2018
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Biomarker discovery study design consistent with the receiver-operator characteristic.
Joakim Ekström1, Ivaylo Stoimenov1, Jim Åkerrén Ögren1
1Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, SE-751 85 Uppsala, Sweden.
Computer Methods and Programs in Biomedicine
|December 24, 2025
Summary
This study proposes a best-practice guideline for biomarker discovery using Receiver-Operator Characteristic (ROC) analysis. The ROC framework helps identify effective biomarkers for clinical use, improving upon current methods.
Area of Science:
- Biomarker Discovery
- Statistical Methodology
- Proteomics
Background:
- Lack of consensus in statistical methods hinders early biomarker discovery.
- Receiver-Operator Characteristic (ROC) analysis is a standard for In Vitro Diagnostic (IVD) device performance.
- Prevalent pitfalls in biomarker discovery need systematic identification and mitigation.
Purpose of the Study:
- To systematically identify and mitigate pitfalls in biomarker discovery.
- To propose a best-practice guideline for biomarker discovery.
- To establish a framework based on ROC analysis for biomarker development.
Main Methods:
- Formulated a biomarker discovery protocol with aligned objectives, sample procurement, and study size determination.
- Utilized Receiver-Operator Characteristic (ROC) framework for data analysis.
- Employed Monte Carlo simulations to guide study design and sample allocation, illustrated with proteomic data.
Main Results:
- Demonstrated a regulatory-adherent pipeline yielding superior effects compared to predicate medical devices.
- Identified statistically significant composite biomarkers using ROC-based analysis on a public dataset.
- Validated a subset of biomarkers in an independent dataset, noting limited overlap with common feature selection methods.
Conclusions:
- The proposed approach facilitates the translation of scientific discoveries into regulatory-approved biomarker tests.
- This framework enhances the clinical utility of newly discovered biomarkers.
- The ROC analysis framework provides a robust method for biomarker validation.

