Assessing the performance of prediction models: A framework for traditional and novel measures Journal Article


Authors: Steyerberg, E. W.; Vickers, A. J.; Cook, N. R.; Gerds, T.; Gonen, M.; Obuchowski, N.; Pencina, M. J.; Kattan, M. W.
Article Title: Assessing the performance of prediction models: A framework for traditional and novel measures
Abstract: The performance of prediction models can be assessed using a variety of methods and metrics. Traditional measures for binary and survival outcomes include the Brier score to indicate overall model performance, the concordance (or c) statistic for discriminative ability (or area under the receiver operating characteristic [ROC] curve), and goodness-of-fit statistics for calibration.Several new measures have recently been proposed that can be seen as refinements of discrimination measures, including variants of the c statistic for survival, reclassification tables, net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Moreover, decision-analytic measures have been proposed, including decision curves to plot the net benefit achieved by making decisions based on model predictions.We aimed to define the role of these relatively novel approaches in the evaluation of the performance of prediction models. For illustration, we present a case study of predicting the presence of residual tumor versus benign tissue in patients with testicular cancer (n = 544 for model development, n = 273 for external validation).We suggest that reporting discrimination and calibration will always be important for a prediction model. Decision-analytic measures should be reported if the predictive model is to be used for clinical decisions. Other measures of performance may be warranted in specific applications, such as reclassification metrics to gain insight into the value of adding a novel predictor to an established model. © 2009 by Lippincott Williams & Wilkins.
Keywords: human tissue; major clinical study; review; neoplasm; reproducibility of results; prediction; risk assessment; models, statistical; clinical decision making; benign tumor; testis cancer; roc curve; epidemiologic studies
Journal Title: Epidemiology
Volume: 21
Issue: 1
ISSN: 1044-3983
Publisher: Lippincott Williams & Wilkins  
Date Published: 2010-01-01
Start Page: 128
End Page: 138
Language: English
DOI: 10.1097/EDE.0b013e3181c30fb2
PUBMED: 20010215
PROVIDER: scopus
PMCID: PMC3575184
DOI/URL:
Notes: --- - "Cited By (since 1996): 23" - "Export Date: 20 April 2011" - "CODEN: EPIDE" - "Source: Scopus"
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Mithat Gonen
    1028 Gonen
  2. Andrew J Vickers
    880 Vickers