Cited by 106Statistical Methods in EpidemiologyStatistical Methods and InferenceMeta-analysis and systematic reviews

Validation of prediction models in the presence of competing risks: a guide through modern methods

Open access
van Geloven, Nan, Giardiello, Daniele, Bonneville, Edouard F, Teece, Lucy, Ramspek, Chava L, van Smeden, Maarten, Snell, Kym I E, van Calster, Ben +4 more·2022·BMJ

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.

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Crossref · 10.1136/bmj-2021-069249

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Authors
van Geloven, N., Giardiello, D., Bonneville, E. F., Teece, L., Ramspek, C. L., van Smeden, M., Snell, K. I. E., van Calster, B., Pohar-Perme, M., Riley, R. D., Putter, H., & Steyerberg, E.
Affiliations
  • Leiden University Medical Center (NL)
  • Keele University (GB)
Corresponding author
Steyerberg, Ewout
Venue
BMJ
Publisher
BMJ
Published
2022-05-24
Volume
377
Pages
e069249
ISSN
1756-1833 (ISSN-L)
OpenAlex
W4281398289
Cited by
106
References
50
Citations by year
2026: 21 · 2025: 32 · 2024: 26 · 2023: 24 · 2022: 3
FWCI
15.67
Type
journal article
Language
en
Open access
Locations
  • BMJ (publishedVersion)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, other-oa)
  • Leiden Repository (Leiden University) (submittedVersion, other-oa)
  • Leiden Repository (Leiden University) (submittedVersion, cc-by-nc)
  • dCOBISS.SI Digital Repository (submittedVersion, other-oa)
  • Keele Research Repository (Keele University) (submittedVersion, cc-by)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion, cc-by-nc)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • BOA (University of Milano-Bicocca) (submittedVersion)
  • Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
  • Lirias (submittedVersion)
  • University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
  • Leiden Repository (Leiden University) (submittedVersion)
Funders
Javna Agencija za Raziskovalno Dejavnost RS (P3-0154)
Topics
  • Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
  • Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods and Inference
  • Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
Keywords
prediction model validation, competing risks, time-to-event outcomes, breast cancer recurrence, model calibration, discrimination (statistics), clinical utility, decision curve analysis, competing events
MeSH terms
Humans, Risk Factors, Models, Statistical, Proportional Hazards Models, Risk Assessment

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