Journal ArticleDOI
Risk prediction models: II. External validation, model updating, and impact assessment
Karel G.M. Moons,Andre Pascal Kengne,Andre Pascal Kengne,Andre Pascal Kengne,Diederick E. Grobbee,Patrick Royston,Yvonne Vergouwe,Douglas G. Altman,Mark Woodward +8 more
TLDR
An overview is provided of the consecutive steps for the assessment of the model's predictive performance in new individuals, how to adjust or update existing models to local circumstances or with new predictors, and how to investigate the impact of the uptake of prediction models on clinical decision-making and patient outcomes (impact studies).Abstract:
Clinical prediction models are increasingly used to complement clinical reasoning and decision-making in modern medicine, in general, and in the cardiovascular domain, in particular. To these ends, developed models first and foremost need to provide accurate and (internally and externally) validated estimates of probabilities of specific health conditions or outcomes in the targeted individuals. Subsequently, the adoption of such models by professionals must guide their decision-making, and improve patient outcomes and the cost-effectiveness of care. In the first paper of this series of two companion papers, issues relating to prediction model development, their internal validation, and estimating the added value of a new (bio)marker to existing predictors were discussed. In this second paper, an overview is provided of the consecutive steps for the assessment of the model's predictive performance in new individuals (external validation studies), how to adjust or update existing models to local circumstances or with new predictors, and how to investigate the impact of the uptake of prediction models on clinical decision-making and patient outcomes (impact studies). Each step is illustrated with empirical examples from the cardiovascular field.read more
Citations
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Journal ArticleDOI
Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis (TRIPOD): explanation and elaboration.
Karel G.M. Moons,Douglas G. Altman,Johannes B. Reitsma,John P. A. Ioannidis,Petra Macaskill,Ewout W. Steyerberg,Andrew J. Vickers,David F. Ransohoff,Gary S. Collins +8 more
TL;DR: In virtually all medical domains, diagnostic and prognostic multivariable prediction models are being developed, validated, updated, and implemented with the aim to assist doctors and individuals in estimating probabilities and potentially influence their decision making.
Journal ArticleDOI
Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): The TRIPOD statement
TL;DR: The TRIPOD Statement aims to improve the transparency of the reporting of a prediction model study regardless of the study methods used, and is best used in conjunction with the TRIPod explanation and elaboration document.
Journal ArticleDOI
Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD): The TRIPOD Statement
TL;DR: The nature of the prediction in diagnosis is estimating the probability that a specific outcome or disease is present (or absent) within an individual, at this point in timethat is, the moment of prediction (T= 0), and prognostic prediction involves a longitudinal relationship.
Journal ArticleDOI
Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): the TRIPOD Statement.
TL;DR: The TRIPOD Statement aims to improve the transparency of the reporting of a prediction model study regardless of the study methods used, and is best used in conjunction with the TRIPod explanation and elaboration document.
Journal ArticleDOI
Critical appraisal and data extraction for systematic reviews of prediction modelling studies: the CHARMS checklist.
Karel G.M. Moons,Joris A. H. de Groot,Walter Bouwmeester,Yvonne Vergouwe,Susan Mallett,Douglas G. Altman,Johannes B. Reitsma,Gary S. Collins +7 more
TL;DR: Carl Moons and colleagues provide a checklist and background explanation for critically appraising and extracting data from systematic reviews of prognostic and diagnostic prediction modelling studies.
References
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Journal ArticleDOI
Prediction of Coronary Heart Disease Using Risk Factor Categories
Peter W.F. Wilson,Ralph B. D'Agostino,Daniel Levy,Albert M. Belanger,Halit Silbershatz,William B. Kannel +5 more
TL;DR: A simple coronary disease prediction algorithm was developed using categorical variables, which allows physicians to predict multivariate CHD risk in patients without overt CHD.
Book
Clinical Prediction Models
TL;DR: This paper presents a case study on survival analysis: Prediction of secondary cardiovascular events and lessons from case studies on overfitting and optimism in prediction models.
Journal ArticleDOI
Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success
TL;DR: Clinicians and other stakeholders should implement clinical decision support systems that incorporate these features whenever feasible and appropriate.
Journal ArticleDOI
Cardiovascular disease risk profiles
TL;DR: The equations demonstrated the potential importance of controlling multiple risk factors (blood pressure, total cholesterol, high-density lipoprotein cholesterol, smoking, glucose intolerance, and left ventricular hypertrophy) as opposed to focusing on one single risk factor.
Journal ArticleDOI
What do we mean by validating a prognostic model
TL;DR: How to validate a model is considered and it is suggested that it is desirable to consider two rather different aspects - statistical and clinical validity - and some general approaches to validation are examined.