Aggregation of Biomarkers and Patient Reported Outcomes

Chakrabartty SN

Published on: 2025-09-11

Abstract

Tailored therapeutic approaches are designed considering relevant biomarkers and outcome measures through PRO-scales, rating scales, tasks related to cognitive impairments, etc. Meaningful aggregation of biomarkers and tasks in ratio scales and ordinal outcome measures generated by PRO-scales, rating scales enables comprehensive assessment of disease status effect of treatment and prognosis for better planning and intervention. The paper transform scores of each chosen biomarkers, item of different PROs and rating scales to follow Normal distribution facilitating meaningful aggregation to get normally distributed indices reflecting overall disease status at a given time point. Normally distributed indicesensure and satisfy basic assumption of parametric ROC-curve for binary classification. The index  facilitates assessment of changes registered by one or a sample of patients over time, identification of critical variables/dimensions requiring immediate necessary corrective action, ranking and classifying regions with respect to ranking of study variables by relative importance and finding equivalent cut-off scores of two PROs or boundary points of two ROC-curves. Normality of indices enables parametric analysis, testing statistical hypothesis across time and space.

Combining ordinal PRO-scores and biomarkers (ratio level) irrespective of PRO-formats and inter-correlations among the indicators is a novelty. Practicing physicians, planners and researchers may derive benefits of the proposed combined scores for meaningful comparisons, better assessment of progress or deterioration, identification of critical indicators for better prognosis, and establishing empirical relationship among the biomarkers and the outcomes.