Abstract
Biomarker discovery involves exploratory analysis to identify informative biomarkers
of interest. The recent development of methods that identify a wider class of
biomarkers that do not have a typical monotone relationship with a binary outcome
has created a need for new methods that can classify biomarkers based on their relationship
with a binary outcome of interest. We discuss three distinct informative
biomarker types: traditional, nontraditional, and restricted traditional, and propose
using a sequence of two hypothesis tests to classify biomarkers into their appropriate
category. The first step uses the area-preserving ROC curve to identify nontraditional
biomarkers. The second step tests for restricted traditional biomarkers. This
test, proposed by Parodi and colleagues, is used to make the final distinction between
traditional and restricted traditional for biomarkers not classified as nontraditional.
We explore the performance of the hypothesis tests under simulation to explore the
merits and limitations of each test. We apply the methods to three mineral and bone
density biomarkers, calcium, phosphorus, and iPTH, using data from the Hemodialysis
Study to ascertain biomarker type.