METHODS article
Front. Res. Metr. Anal.
Sec. Research Methods
Guidelines for Setting Cut-off Scores in AUC (AUC-GUIDE): Balancing Sensitivity, Specificity, and Purpose
Sarawak General Hospital, Kuching, Malaysia
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Abstract
Determining ideal cut-off scores is a critical step in screening and diagnostic test evaluation. While the Area Under the Curve (AUC) with Receiver Operating Characteristic (ROC) curve are frequently reported, these do not directly indicate the best threshold for decision-making. In addition, pursuing an optimal solution might not always be practical. This paper presents a practical guideline for selecting cut-off scores based on AUC values in conjunction with sensitivity, specificity, and intended scientific use. The study outline recommended strategies for different AUC ranges, incorporating realistic considerations and scientific priorities. The framework offers flexibility, including when to prioritize sensitivity, specificity, or balanced performance via Youden's Index and other techniques. This guideline aims to support researchers and clinicians in making evidence-based, transparent, and context-sensitive decisions when interpreting screening or diagnostic accuracy results.
Summary
Keywords
AUC, diagnostic, screening, Sensitivity, specificity
Received
11 February 2026
Accepted
20 May 2026
Copyright
© 2026 BUJANG. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: MOHAMAD ADAM BUJANG
Disclaimer
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