Efficient Variance Estimation for the Polytomous Discrimination Index

Stat Med. 2026 Aug;45(18-19):e70690. doi: 10.1002/sim.70690.

ABSTRACT

Evaluating diagnostic accuracy for multi-category outcomes remains a significant challenge, primarily due to computational limitations in existing performance metrics. The Polytomous Discrimination Index (PDI) has emerged as an order-agnostic solution suitable for nominal classifications. However, its broader adoption has been constrained by the lack of efficient implementation, especially for its variance estimation, which typically would require computationally intensive bootstrapping procedures. In this work, we address this limitation by proposing a novel asymptotic variance estimator for the PDI. Our method integrates classical U -statistic theory with recent advances in combinatorics, offering a scalable and theoretically grounded alternative. To assess the performance of the proposed approach, we conduct extensive simulation studies and observe remarkable gain in computing time. We further apply our method to a real-world brain image analysis where deep neural networks are used as a diagnostic tool. We can efficiently report the accuracy of the neural networks with different depth specifications.

PMID:42572921 | DOI:10.1002/sim.70690