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Prognosis Research Strategy (PROGRESS) 2: Prognostic Factor Research
Open accessAbstract
Prognostic factor research aims to identify factors associated with subsequent clinical outcome in people with a particular disease or health condition.In this article, the second in the PROGRESS series, the authors discuss the role of prognostic factors in current clinical practice, randomised trials, and developing new interventions, and explain why and how prognostic factor research should be improved.The Guidelines and Guidance section contains advice on conducting and reporting medical research.
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![Figure 1 Tumour grade as a prognostic factor in breast cancer. Kaplan-Meier curves for disease-free survival for three groups of breast cancer patients defined by tumour grade status (1, 2, or 3). Curves are derived from 246 breast cancer patients treated with tamoxifen who had 94 recurrences or deaths over a possible 7 years of follow-up (reproduced with published data relating to Schumacher et al [1]). The distinct curves, significant log rank result, and hazard ratio estimates suggests tumour grade is a prognostic factor, as it identifies three groups of patients with a different average prognosis.](/paper-figures/0d235379357046068c117f4c81d2cdb6/prognosis-research-strategy-progress-2-prognostic-factor-research-figure-1.jpg)
![Figure 2 Evaluation of whether homocysteine is a prognostic factor, and whether modifying it improves clinical outcome in patients with coronary disease (drawn from data in [35]). Path element adapted from Chart 7.1 in the Cooksey report (2006) http://bit.ly/Ro27rL (made available for use and re-use through the Open Government License).](/paper-figures/f22651a05c0b49db8bbde8bd6a31e883/prognosis-research-strategy-progress-2-prognostic-factor-research-figure-2.jpg)
![Figure 3 Discovery of prognostic factors: a genome-wide association study of survival among people with breast cancer, and replication in 15 studies (Mid-figure forest plot based on example plots in [4]. Path element adapted from Chart 7.1 in the Cooksey report (2006) http://bit.ly/Ro27rL (made available for use and re-use through the Open Government License).](/paper-figures/12da3f48cb59477b986b11319b011816/prognosis-research-strategy-progress-2-prognostic-factor-research-figure-3.jpg)
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“In both the diagnostic and prognostic setting, estimates of probabilities are rarely based on a single predictor [5].”
From Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): the TRIPOD Statement (2015) · cites this paper as [5]
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“In both the diagnostic and prognostic setting, estimates of probabilities are rarely based on a single predictor.5”
From Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis (TRIPOD): The TRIPOD Statement (2015) · cites this paper as [5]
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Metadata
- Authors
- Riley, R. D., Hayden, J. A., Steyerberg, E. W., Moons, K. G. M., Abrams, K., Kyzas, P. A., Malats, N., Briggs, A., Schroter, S., Altman, D. G., Hemingway, H., & for the PROGRESS Group
- Affiliations
- University of Birmingham (GB)
- Dalhousie University (CA)
- Erasmus MC (NL)
- University Medical Center Utrecht (NL)
- University of Leicester (GB)
- North Manchester General Hospital (GB)
- Spanish National Cancer Research Centre (ES)
- University of Glasgow (GB)
- BMJ Group (United Kingdom) (GB)
- University of Oxford (GB)
- University College London (GB)
- Corresponding author
- Riley, Richard D.
- ORCID
- Venue
- PLoS Medicine
- Publisher
- Public Library of Science (PLoS)
- Published
- 2013-02-05
- Volume
- 10
- Issue
- 2
- Pages
- e1001380
- ISSN
- 1549-1277 (ISSN-L)
- 1549-1676
- PMC
- PMC3564757
- OpenAlex
- W2100741073
- Cited by
- 823
- References
- 71
- Citations by year
- 2026: 68 · 2025: 72 · 2024: 60 · 2023: 88 · 2022: 95 · 2021: 79 · 2020: 83 · 2019: 44 · 2018: 50 · 2017: 37 · 2016: 37 · 2015: 46 · 2014: 48 · 2013: 15
- FWCI
- 9.57
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS Medicine (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (acceptedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UCL Discovery (University College London) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Leicester Research Archive (University of Leicester) (submittedVersion, other-oa)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion, other-oa)
- Funders
- Queen Mary University of London
- National Institute for Social Care and Health Research
- London School of Hygiene and Tropical Medicine
- Wellcome Trust (086091, 086091/Z/08/Z)
- Nova Scotia Health Research Foundation
- Cancer Research UK (C5529)
- National Institute for Health and Care Research (NF-SI-0509-10183, NI-SI-0508-10061, RP-PG-0407-10314, NF-SI-0512-10159, RP-PG-0407-10386)
- British Heart Foundation
- University of Birmingham
- Dalhousie University
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek (918.10.615)
- Center for Translational Molecular Medicine (03O-203)
- Versus Arthritis
- Canadian Institutes of Health Research
- Medical Research Council (G0800808, G0902393)
- Engineering and Physical Sciences Research Council
- Economic and Social Research Council
- Topics
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Clinical Trials
- Keywords
- prognostic factors, prognosis, clinical outcomes, research strategies, randomised trials, intervention development, research reporting, clinical practice
- MeSH terms
- Decision Support Techniques, Health Services Research, Humans, Predictive Value of Tests, Prognosis, Research Design, Risk Factors, Biomarkers, Randomized Controlled Trials as Topic, Treatment Outcome, Disease Progression, Risk Assessment, Biomedical Research
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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