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

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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.

Acceptance Date Apr 8, 2022
Publication Date May 24, 2022
Publicly Available Date Mar 29, 2024
Journal BMJ
Print ISSN 0959-8138
Publisher BMJ Publishing Group
Pages e069249 - ?
DOI https://doi.org/10.1136/bmj-2021-069249
Publisher URL https://www.bmj.com/content/377/bmj-2021-069249

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