Homogeneity tests of clustered diagnostic markers with applications to the BioCycle Study

Liansheng Larry Tang, Aiyi Liu, Enrique F. Schisterman, Xiao Hua Zhou, Chunling Liu

Research output: Journal article publicationJournal articleAcademic researchpeer-review

1 Citation (Scopus)


Diagnostic trials often require the use of a homogeneity test among several markers. Such a test may be necessary to determine the power both during the design phase and in the initial analysis stage. However, no formal method is available for the power and sample size calculation when the number of markers is greater than two and marker measurements are clustered in subjects. This article presents two procedures for testing the accuracy among clustered diagnostic markers. The first procedure is a test of homogeneity among continuous markers based on a global null hypothesis of the same accuracy. The result under the alternative provides the explicit distribution for the power and sample size calculation. The second procedure is a simultaneous pairwise comparison test based on weighted areas under the receiver operating characteristic curves. This test is particularly useful if a global difference among markers is found by the homogeneity test. We apply our procedures to the BioCycle Study designed to assess and compare the accuracy of hormone and oxidative stress markers in distinguishing women with ovulatory menstrual cycles from those without.
Original languageEnglish
Pages (from-to)3638-3648
Number of pages11
JournalStatistics in Medicine
Issue number28
Publication statusPublished - 10 Dec 2012


  • Biomarker
  • Homogeneity test
  • ROC curve
  • Sample size

ASJC Scopus subject areas

  • Epidemiology
  • Statistics and Probability


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