The DOI matches its Crossref record; 21 of the 21 references it cites were found in a registry or an index.
Decision curve analysis to evaluate the clinical benefit of prediction models
Open accessAbstract
There is increased interest in the use of prediction models to guide clinical decision-making in orthopedics. Prediction models are typically evaluated in terms of their accuracy: discrimination (area-under-the-curve [AUC] or concordance index) and calibration (a plot of predicted vs. observed risk). But it can be hard to know how high an AUC has to be in order to be “high enough” to warrant use of a prediction model, or how much miscalibration would be disqualifying. Decision curve analysis was developed as a method to determine whether use of a prediction model in the clinic to inform decision-making would do more good than harm. Here we give a brief introduction to decision curve analysis, explaining the critical concepts of net benefit and threshold probability. We briefly review some prediction models reported in the orthopedic literature, demonstrating how use of decision curves has allowed conclusions as to the clinical value of a prediction model. Conversely, papers without decision curves were unable to address questions of clinical value. We recommend increased use of decision curve analysis to evaluate prediction models in the orthopedics literature.
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Cites
Decision curve analysis: a novel method for evaluating prediction models
Vickers, A. J., & Elkin, E. B. (2006) · Medical Decision Making · doi:10.1177/0272989x06295361 · Cited by 6,341
Self-citationMoons, K. G. M., Altman, D. G., Reitsma, J. B., Ioannidis, J. P. A., Macaskill, P., Steyerberg, E. W., Vickers, A. J., Ransohoff, D. F., & Collins, G. S. (2015) · Annals of Internal Medicine · doi:10.7326/m14-0698 · Cited by 5,147
Self-citationCalibration: the Achilles heel of predictive analytics
On behalf of Topic Group ‘Evaluating diagnostic tests and prediction models’ of the STRATOS initiative, Van Calster, B., McLernon, D. J., van Smeden, M., Wynants, L., & Steyerberg, E. W. (2019) · BMC Medicine · doi:10.1186/s12916-019-1466-7 · Cited by 2,650
Reporting and Interpreting Decision Curve Analysis: A Guide for Investigators
Van Calster, B., Wynants, L., Verbeek, J. F. M., Verbakel, J. Y., Christodoulou, E., Vickers, A. J., Roobol, M. J., & Steyerberg, E. W. (2018) · European Urology · doi:10.1016/j.eururo.2018.08.038 · Cited by 1,271
Self-citationA simple, step-by-step guide to interpreting decision curve analysis
Vickers, A. J., van Calster, B., & Steyerberg, E. W. (2019) · Diagnostic and Prognostic Research · doi:10.1186/s41512-019-0064-7 · Cited by 1,174
Self-citationVickers, A. J., Van Calster, B., & Steyerberg, E. W. (2016) · BMJ · doi:10.1136/bmj.i6 · Cited by 1,163
Self-citationFitzgerald, M., Saville, B. R., & Lewis, R. J. (2015) · JAMA · doi:10.1001/jama.2015.37 · Cited by 787
Kerr, K. F., Brown, M. D., Zhu, K., & Janes, H. (2016) · Journal of Clinical Oncology · doi:10.1200/jco.2015.65.5654 · Cited by 697
Anemia and Patient Blood Management in Hip and Knee Surgery: A Systematic Review of the Literature
Spahn, D. R. (2010) · Anesthesiology · doi:10.1097/aln.0b013e3181e08e97 · Cited by 650
Fourney, D. R., Frangou, E. M., Ryken, T. C., DiPaola, C. P., Shaffrey, C. I., Berven, S. H., Bilsky, M. H., Harrop, J. S., Fehlings, M. G., Boriani, S., et al. (2011) · Journal of Clinical Oncology · doi:10.1200/jco.2010.34.3897 · Cited by 551
Cited by
Wu, L., Mai, L., Wang, H., Huang, J., He, X., Zhan, X., Khalemsky, A., Kumar, V. A., Paxton, J. H., Tsilimingras, D., et al. (2026) · npj Digital Medicine · doi:10.1038/s41746-026-02522-8 · Cited by 8
Metadata
- Authors
- Vickers, A. J., & Holland, F.
- Venue
- The Spine Journal
- Publisher
- Elsevier BV
- Published
- 2021-10
- Volume
- 21
- Issue
- 10
- Pages
- 1643-1648
- ISSN
- 1529-9430 (ISSN-L)
- OpenAlex
- W3135278199
- Cited by
- 394
- References
- 21
- FWCI
- 34.39
- Type
- journal article
- Language
- en
- Open access
- green
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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