Correcting for Confounding in Analyzing Receiver Operating Characteristic Curves

A method is described for modeling a receiver operating curve as a function of confounding covariates when the outcome of the screening test is a continuous variate. A parametric survival model is proposed for modeling the distribution of the screening test outcome as a function of true disease status and other confounding covariates. The sensitivity and specificity of the screening test at any “cut‐point” along the range of the screening test outcome may be estimated easily from the estimated survival distribution. Confidence intervals and an estimate of the area under the curve are derived.