Validation of prediction models in the presence of competing risks: a guide through modern methods. (24th May 2022)

• Record Type: Journal Article
• Authors: van Geloven, Nan; Giardiello, Daniele; Bonneville, Edouard F; Teece, Lucy; Ramspek, Chava L; van Smeden, Maarten; Snell, Kym I E; van Calster, Ben; Pohar-Perme, Maja; Riley, Richard D; Putter, Hein; Steyerberg, Ewout
• Is Part Of: BMJ. Volume 377(2022)
• Publication Date: 2022-05-24
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Periodicals; 610
• DOI: 10.1136/bmj-2021-069249
• Languages: English
• ISSNs: 0007-1447

Abstract

Abstract : Thorough validation is pivotal for any prediction model before it can be advocated for use in medical practice. For time-to-event outcomes such as breast cancer recurrence, death from other causes is a competing risk. Model performance measures must account for such competing events. In this article, we present a comprehensive yet accessible overview of performance measures for this competing event setting, including the calculation and interpretation of statistical measures for calibration, discrimination, overall prediction error, and clinical usefulness by decision curve analysis. All methods are illustrated for patients with breast cancer, with publicly available data and R code.