Beyond self-reports: Changes in biomarkers as predictors of mortality

The proliferation of biosocial surveys has increased the importance of weighing the costs and benefits of adding biomarker collection to population-based surveys. A crucial question is whether biomarkers offer incremental value beyond self-reported measures, which are easier to collect and impose less respondent burden. We use longitudinal data from a nationally representative sample of older Taiwanese (aged 54+ in 2000, examined in 2000 and 2006 with mortality follow-up through 2011) to address that question with respect to predicting all-cause mortality. A summary measure of biomarkers improves mortality prediction (as measured by the area under the receiver operating characteristic curve) compared with self-reports alone, but individual biomarkers perform better than the summary score. We find that incorporating change in biomarkers over a six-year period yields a small improvement in mortality prediction compared with one-time measurement. But, is the incremental value worth the costs?.