Risk prediction models: II. External validation, model updating, and impact assessment.

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...

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Main Authors: Moons, K, Kengne, A, Grobbee, D, Royston, P, Vergouwe, Y, Altman, D, Woodward, M
Format: Journal article
Language:English
Published: 2012
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author Moons, K
Kengne, A
Grobbee, D
Royston, P
Vergouwe, Y
Altman, D
Woodward, M
author_facet Moons, K
Kengne, A
Grobbee, D
Royston, P
Vergouwe, Y
Altman, D
Woodward, M
author_sort Moons, K
collection OXFORD
description 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.
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spelling oxford-uuid:5ea260a7-2dd8-4536-8887-9d488a6705c92022-03-26T17:41:55ZRisk prediction models: II. External validation, model updating, and impact assessment.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:5ea260a7-2dd8-4536-8887-9d488a6705c9EnglishSymplectic Elements at Oxford2012Moons, KKengne, AGrobbee, DRoyston, PVergouwe, YAltman, DWoodward, MClinical 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.
spellingShingle Moons, K
Kengne, A
Grobbee, D
Royston, P
Vergouwe, Y
Altman, D
Woodward, M
Risk prediction models: II. External validation, model updating, and impact assessment.
title Risk prediction models: II. External validation, model updating, and impact assessment.
title_full Risk prediction models: II. External validation, model updating, and impact assessment.
title_fullStr Risk prediction models: II. External validation, model updating, and impact assessment.
title_full_unstemmed Risk prediction models: II. External validation, model updating, and impact assessment.
title_short Risk prediction models: II. External validation, model updating, and impact assessment.
title_sort risk prediction models ii external validation model updating and impact assessment
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AT roystonp riskpredictionmodelsiiexternalvalidationmodelupdatingandimpactassessment
AT vergouwey riskpredictionmodelsiiexternalvalidationmodelupdatingandimpactassessment
AT altmand riskpredictionmodelsiiexternalvalidationmodelupdatingandimpactassessment
AT woodwardm riskpredictionmodelsiiexternalvalidationmodelupdatingandimpactassessment