Jenkins, DA, Martin, GP, Sperrin, M, Riley, RD ORCID: https://orcid.org/0000-0001-8699-0735, Debray, TPA, Collins, GS and Peek, N (2021) Continual updating and monitoring of clinical prediction models: time for dynamic prediction systems? Diagnostic and Prognostic Research, 5 (1). 1 - ?.

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Abstract

Clinical prediction models (CPMs) have become fundamental for risk stratification across healthcare. The CPM pipeline (development, validation, deployment, and impact assessment) is commonly viewed as a one-time activity, with model updating rarely considered and done in a somewhat ad hoc manner. This fails to address the fact that the performance of a CPM worsens over time as natural changes in populations and care pathways occur. CPMs need constant surveillance to maintain adequate predictive performance. Rather than reactively updating a developed CPM once evidence of deteriorated performance accumulates, it is possible to proactively adapt CPMs whenever new data becomes available. Approaches for validation then need to be changed accordingly, making validation a continuous rather than a discrete effort. As such, "living" (dynamic) CPMs represent a paradigm shift, where the analytical methods dynamically generate updated versions of a model through time; one then needs to validate the system rather than each subsequent model revision.

Item Type: Article
Additional Information: This is the final published version of the article (version of record). It first appeared online via BioMed Central Springer Nature at https://doi.org/10.1186/s41512-020-00090-3 - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: Clinical prediction models, Dynamic model, Learning health system, Model development, Model updating, Validation
Subjects: R Medicine > RC Internal medicine
Divisions: Faculty of Medicine and Health Sciences > School of Primary, Community and Social Care
Related URLs:
Depositing User: Symplectic
Date Deposited: 22 Apr 2021 11:23
Last Modified: 22 Apr 2021 11:27
URI: https://eprints.keele.ac.uk/id/eprint/9407

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