Using Copula Functions to Estimate The AUC for Two Dependent Diagnostic Tests

When performing validation studies on diagnostic classification procedures, one or more biomarkers are typically measured in individuals. Some of these biomarkers may provide better information; moreover, more than one biomarker may be significant and may exhibit dependence between them. This proposal intends to estimate the Area Under the Receiver Operating  Characteristic Curve  (AUC)  for classifying individuals in a screening study. We analyze the dependence between the results of the tests by means of copula-type dependence (using FGM and Gumbel-Barnett copula functions), and studying the respective AUC under this type of dependence. Three different dependence-level values were evaluated for each copula function considered. In most of the reviewed literature, the authors assume a normal model to represent the performance of the biomarkers used for clinical diagnosis. There are situations in which assuming normality is not possible because that model is not suitable for one or both biomarkers. The proposed statistical model does not depend on some distributional assumption for the biomarkers used for diagnosis procedure, and additionally, it is not necessary to observe a strong or moderate linear dependence between them.