Advanced Search
MyIDEAS: Login to save this article or follow this journal

Exact confidence interval estimation for the Youden index and its corresponding optimal cut-point


Author Info

  • Lai, Chin-Ying
  • Tian, Lili
  • Schisterman, Enrique F.
Registered author(s):


    In diagnostic studies, the receiver operating characteristic (ROC) curve and the area under the ROC curve are important tools in assessing the utility of biomarkers in discriminating between non-diseased and diseased populations. For classifying a patient into the non-diseased or diseased group, an optimal cut-point of a continuous biomarker is desirable. Youden’s index (J), defined as the maximum vertical distance between the ROC curve and the diagonal line, serves as another global measure of overall diagnostic accuracy and can be used in choosing an optimal cut-point. The proposed approach is to make use of a generalized approach to estimate the confidence intervals of the Youden index and its corresponding optimal cut-point. Simulation results are provided for comparing the coverage probabilities of the confidence intervals based on the proposed method with those based on the large sample method and the parametric bootstrap method. Finally, the proposed method is illustrated via an application to a data set from a study on Duchenne muscular dystrophy (DMD).

    Download Info

    If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
    File URL:
    Download Restriction: Full text for ScienceDirect subscribers only.

    As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.

    Bibliographic Info

    Article provided by Elsevier in its journal Computational Statistics & Data Analysis.

    Volume (Year): 56 (2012)
    Issue (Month): 5 ()
    Pages: 1103-1114

    as in new window
    Handle: RePEc:eee:csdana:v:56:y:2012:i:5:p:1103-1114

    Contact details of provider:
    Web page:

    Related research

    Keywords: Confidence interval; ROC curve; Sensitivity and specificity; Youden index; Optimal cut-point; Generalized pivotal quantity;


    References listed on IDEAS
    Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
    as in new window
    1. Tian, Lili & Wilding, Gregory E., 2008. "Confidence interval estimation of a common correlation coefficient," Computational Statistics & Data Analysis, Elsevier, vol. 52(10), pages 4872-4877, June.
    2. Gamage, Jinadasa & Mathew, Thomas & Weerahandi, Samaradasa, 2004. "Generalized p-values and generalized confidence regions for the multivariate Behrens-Fisher problem and MANOVA," Journal of Multivariate Analysis, Elsevier, vol. 88(1), pages 177-189, January.
    Full references (including those not matched with items on IDEAS)


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as in new window

    Cited by:
    1. Rota, Matteo & Antolini, Laura, 2014. "Finding the optimal cut-point for Gaussian and Gamma distributed biomarkers," Computational Statistics & Data Analysis, Elsevier, vol. 69(C), pages 1-14.


    This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.


    Access and download statistics


    When requesting a correction, please mention this item's handle: RePEc:eee:csdana:v:56:y:2012:i:5:p:1103-1114. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Zhang, Lei).

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If references are entirely missing, you can add them using this form.

    If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.