DIAGNOSTIC PREDICTION RULES: PRINCIPLES, REQUIREMENTS, AND PITFALLS
Abstract
This article focuses on the background, principles, requirements, and pitfalls of diagnostic prediction rules. Useful rules can only be derived from methodologically valid data bases. By considering the possibilities and limitations of prediction rules, the author concludes that these rules may support medical decision making, but cannot be a substitute for clinical skills and solid pathophysiologic knowledge.
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It is essential that key details of how a prediction model was developed and validated be clearly reported to enable synthesis and critical appraisal of all relevant information.
“It is therefore essential that key details of how a prediction model was developed and validated be clearly reported to enable synthesis and critical appraisal of all relevant information.14,33–36”
From Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis (TRIPOD): The TRIPOD Statement (2015) · cites this paper as [36]
Cites
Epidemiologic Research: Principles and Quantitative Methods.
Pocock, S., Kleinbaum, D. G., Kupper, L. L., & Morgenstern, H. (1983) · Biometrics · doi:10.2307/2531133 · Cited by 1,893 · see citing works
Problems of Spectrum and Bias in Evaluating the Efficacy of Diagnostic Tests
Ransohoff, D. F., & Feinstein, A. R. (1978) · New England Journal of Medicine · doi:10.1056/nejm197810262991705 · Cited by 1,739 · see citing works
Fischhoff, B. (1980) · Operations Research · doi:10.1287/opre.28.1.28 · Cited by 1,423 · see citing works
Statistical Methods in Medical Research.
Wickham, C. A. C., Armitage, P., & Berry, G. (1988) · Journal of the Royal Statistical Society Series A (Statistics in Society) · doi:10.2307/2982765 · Cited by 1,410 · see citing works
The Threshold Approach to Clinical Decision Making
Pauker, S. G., & Kassirer, J. P. (1980) · New England Journal of Medicine · doi:10.1056/nejm198005153022003 · Cited by 1,371 · see citing works
Clinical Prediction Rules: Applications and Methodological Standards
Wasson, J. H., Sox, H. C., Neff, R. K., & Goldman, L. (1985) · New England Journal of Medicine · doi:10.1056/nejm198509263131306 · Cited by 1,357 · see citing works
Starfield, B. H. (1994) · The Lancet · doi:10.1016/s0140-6736(94)90634-3 · Cited by 1,153 · see citing works
Assessment of diagnostic tests when disease verification is subject to selection bias
Begg, C. B., & Greenes, R. A. (1983) · Biometrics · doi:10.2307/2530820 · Cited by 708 · see citing works
Miller, R. A. (1994) · Journal of the American Medical Informatics Association · doi:10.1136/jamia.1994.95236141 · Cited by 460 · see citing works
Spiegelhalter, D. J., & Knill-Jones, R. P. (1984) · Journal of the Royal Statistical Society Series A (General) · doi:10.2307/2981737 · Cited by 314 · see citing works
Primary care and health. A cross-national comparison
Starfield, B. H. (1991) · JAMA · doi:10.1001/jama.266.16.2268 · Cited by 238 · see citing works
The influence of referral patterns on the characteristics of diagnostic tests
AndréKnorrnerus, J., & Leffers, P. (1992) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(92)90155-g · Cited by 143 · see citing works
AUERBACH, P. S. (2009) · Elsevier eBooks · doi:10.1016/b978-0-323-06813-0.50008-0 · Cited by 137 · see citing works
The Effects of Disease Verification and Referral on the Relationship Between Symptoms and Diseases
Knottnerus, J. A. (1987) · Medical Decision Making · doi:10.1177/0272989x8700700304 · Cited by 91 · see citing works
Self-citationMedical Decision Making By General Practitioners and Specialists
Knottnerus, J. (1991) · Family Practice · doi:10.1093/fampra/8.4.305 · Cited by 85 · see citing works
Self-citationMorise, A. P., Detrano, R., Bobbio, M., et al. (1992) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(92)90377-y · Cited by 79 · see citing works
Nease, R. F., & Owens, D. K. (1994) · Medical Decision Making · doi:10.1177/0272989x9401400409 · Cited by 72 · see citing works
Application of Logistic Regression to the Analysis of Diagnostic Data
Knottnerus, J. A. (1992) · Medical Decision Making · doi:10.1177/0272989x9201200202 · Cited by 51 · see citing works
Self-citationStarmans, R., Muris, J. W. M., Fijten, G. H., Schouten, H. J. A., Pop, P., & Knottnerus, J. A. (1994) · Medical Decision Making · doi:10.1177/0272989x9401400302 · Cited by 35 · see citing works
Self-citationInterpretation of diagnostic data: an unexplored field in general practice.
Knottnerus, J. A. (1985) · PubMed Central · Cited by 27 · see citing works
Self-citationTaking a Calculated Risk: Predictive Scoring Systems in Dyspepsia
Spiegelhalter, D. J., Crean, G. P., Holden, R., et al. (1987) · Scandinavian Journal of Gastroenterology · doi:10.3109/00365528709090984 · Cited by 23 · see citing works
Reproducibility of Predictor Variables from a Validated Clinical Rule
Heckerling, P. S., Conant, R. C., Tape, T. G., et al. (1992) · Medical Decision Making · doi:10.1177/0272989x9201200406 · Cited by 18 · see citing works
Formal decision supports in medical practice and education
Christensen, C., Elstein, A. S., Bernstein, L. M., & Balla, J. I. (1991) · Teaching and Learning in Medicine · doi:10.1080/10401339109539484 · Cited by 5 · see citing works
Knottnerus, J. A. (1992) · Medical Decision Making · doi:10.1177/0272989x9201200407 · Cited by 5 · see citing works
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Collins, G. S., Reitsma, J. B., Altman, D. G., & Moons, K. G. M. (2015) · BMJ · doi:10.1136/bmj.g7594 · Cited by 4,388 · see citing works
Collins, G. S., Reitsma, J. B., Altman, D. G., & Moons, K. G. M. (2015) · Annals of Internal Medicine · doi:10.7326/m14-0697 · Cited by 3,267 · see citing works
PROBAST: A Tool to Assess the Risk of Bias and Applicability of Prediction Model Studies
Wolff, R. F., Moons, K. G. M., Riley, R. D., Whiting, P. F., Westwood, M., Collins, G. S., Reitsma, J. B., Kleijnen, J., Mallett, S., & for the PROBAST Group† (2019) · Annals of Internal Medicine · doi:10.7326/m18-1376 · Cited by 2,984 · see citing works
Collins, G. S., Reitsma, J. B., Altman, D. G., & Moons, K. (2015) · BMC Medicine · doi:10.1186/s12916-014-0241-z · Cited by 1,927 · see citing works
Collins, G. S., Reitsma, J. B., Altman, D. G., & Moons, K. G. M. (2015) · Circulation · doi:10.1161/circulationaha.114.014508 · Cited by 793 · see citing works
Debray, T. P. A., Vergouwe, Y., Koffijberg, H., Nieboer, D., Steyerberg, E. W., & Moons, K. G. M. (2015) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2014.06.018 · Cited by 597 · see citing works
Collins, G. S., Reitsma, J. B., Altman, D. G., & Moons, K. G. M. (2015) · European Urology · doi:10.1016/j.eururo.2014.11.025 · Cited by 439 · see citing works
Diagnosis of the condition of the dental pulp: a systematic review
Mejàre, I. A., Axelsson, S., Davidson, T., Frisk, F., Hakeberg, M., Kvist, T., Norlund, A., Petersson, A., Portenier, I., Sandberg, H., et al. (2012) · International Endodontic Journal · doi:10.1111/j.1365-2591.2012.02016.x · Cited by 296 · see citing works
- Authors
- Knottnerus, J. A.
- Venue
- Primary Care: Clinics in Office Practice
- Publisher
- Elsevier BV
- Published
- 1995-06
- Volume
- 22
- Issue
- 2
- Pages
- 341-363
- ISSN
- 0095-4543 (ISSN-L)
- OpenAlex
- W2405220364
- Cited by
- 56
- References
- 24
- Citations by year
- 2024: 1 · 2022: 1 · 2019: 1 · 2018: 1 · 2017: 1 · 2016: 1 · 2015: 13 · 2014: 4 · 2013: 1 · 2012: 2
- FWCI
- 1.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Primary Care Clinics in Office Practice (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Health Sciences › Health Professions › Health Information Management › Artificial Intelligence in Healthcare
- Keywords
- clinical decision rules, clinical decision-making, clinical judgment, evidence-based medicine
- MeSH terms
- Decision Support Techniques, Diagnosis, Humans, Outcome and Process Assessment, Health Care, Predictive Value of Tests, Primary Health Care, Multivariate Analysis, Logistic Models
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