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OptimalCutpoints: An R Package for Selecting Optimal Cutpoints in Diagnostic Tests

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  • López-Ratón, Mónica
  • Rodríguez-Álvarez, María Xosé
  • Cadarso-Suárez, Carmen
  • Gude-Sampedro, Francisco

Abstract

Continuous diagnostic tests are often used for discriminating between healthy and diseased populations. For the clinical application of such tests, it is useful to select a cutpoint or discrimination value c that defines positive and negative test results. In general, individuals with a diagnostic test value of c or higher are classified as diseased. Several search strategies have been proposed for choosing optimal cutpoints in diagnostic tests, depending on the underlying reason for this choice. This paper introduces an R package, known as OptimalCutpoints, for selecting optimal cutpoints in diagnostic tests. It incorporates criteria that take the costs of the different diagnostic decisions into account, as well as the prevalence of the target disease and several methods based on measures of diagnostic test accuracy. Moreover, it enables optimal levels to be calculated according to levels of given (categorical) covariates. While the numerical output includes the optimal cutpoint values and associated accuracy measures with their confidence intervals, the graphical output includes the receiver operating characteristic (ROC) and predictive ROC curves. An illustration of the use of OptimalCutpoints is provided, using a real biomedical dataset.

Suggested Citation

  • López-Ratón, Mónica & Rodríguez-Álvarez, María Xosé & Cadarso-Suárez, Carmen & Gude-Sampedro, Francisco, 2014. "OptimalCutpoints: An R Package for Selecting Optimal Cutpoints in Diagnostic Tests," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 61(i08).
    • Handle: RePEc:jss:jstsof:v:061:i08
    DOI: http://hdl.handle.net/10.18637/jss.v061.i08
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    1. Lausen, Berthold & Schumacher, Martin, 1996. "Evaluating the effect of optimized cutoff values in the assessment of prognostic factors," Computational Statistics & Data Analysis, Elsevier, vol. 21(3), pages 307-326, March.
    2. Edward J. Boyko, 1994. "Ruling Out or Ruling In Disease with the Most sensitiue or Specific Diagnostic Test," Medical Decision Making, , vol. 14(2), pages 175-179, April.
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    5. Antonio M. Salcedo & Gregorio Izquierdo Llanes, 2020. "Refining the Monetary Poverty Indicators Under a Join Income-Consumption Statistical Approach: An Application to Spain Based on Empirical Data," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 147(2), pages 501-516, January.
    6. Oke Gerke & Antonia Zapf, 2022. "Convergence Behavior of Optimal Cut-Off Points Derived from Receiver Operating Characteristics Curve Analysis: A Simulation Study," Mathematics, MDPI, vol. 10(22), pages 1-14, November.
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