A calibration hierarchy for risk models was defined: from utopia to empirical data

Journal of Clinical Epidemiology
Ben Van CalsterEwout W Steyerberg

Abstract

Calibrated risk models are vital for valid decision support. We define four levels of calibration and describe implications for model development and external validation of predictions. We present results based on simulated data sets. A common definition of calibration is "having an event rate of R% among patients with a predicted risk of R%," which we refer to as "moderate calibration." Weaker forms of calibration only require the average predicted risk (mean calibration) or the average prediction effects (weak calibration) to be correct. "Strong calibration" requires that the event rate equals the predicted risk for every covariate pattern. This implies that the model is fully correct for the validation setting. We argue that this is unrealistic: the model type may be incorrect, the linear predictor is only asymptotically unbiased, and all nonlinear and interaction effects should be correctly modeled. In addition, we prove that moderate calibration guarantees nonharmful decision making. Finally, results indicate that a flexible assessment of calibration in small validation data sets is problematic. Strong calibration is desirable for individualized decision support but unrealistic and counter productive by stimulating the dev...Continue Reading

References

Jul 31, 1975·The New England Journal of Medicine·S G Pauker, J P Kassirer
Jan 1, 1993·Medical Decision Making : an International Journal of the Society for Medical Decision Making·M E MillerC J McDonald
May 15, 1997·Statistics in Medicine·D W HosmerS Lemeshow
Sep 14, 2002·Statistics in Medicine·David W Hosmer, Nils Lid Hjort
Aug 3, 2004·Statistics in Medicine·Ewout W SteyerbergJ Dik F Habbema
Oct 12, 2005·Statistics in Medicine·Patrick RoystonWilli Sauerbrei
Nov 14, 2006·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Andrew J Vickers, Elena B Elkin
Jul 29, 2009·BMC Medical Research Methodology·Szilard NemesGunnar Steineck
May 8, 2010·Journal of the American Statistical Association·Raymond J CarrollPeter Hall
Nov 23, 2010·Biostatistics·Kyung In Kim, Richard Simon
Jan 15, 2013·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Ben Van CalsterEwout W Steyerberg
Jul 16, 2013·Journal of Clinical Epidemiology·Kirsten Van HoordeBen Van Calster
Sep 12, 2013·Journal of Clinical Epidemiology·Werner Vach
Mar 22, 2014·BMC Medical Research Methodology·Gary S CollinsDouglas G Altman
Jun 5, 2014·Statistics in Medicine·Peter C Austin, Ewout W Steyerberg
Aug 27, 2014·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Ben Van Calster, Andrew J Vickers
Jan 13, 2015·Journal of Biomedical Informatics·K Van HoordeB Van Calster
Feb 24, 2015·Journal of Clinical Epidemiology·Peter C Austin, Ewout W Steyerberg

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Citations

Jan 24, 2016·American Journal of Obstetrics and Gynecology·Dirk TimmermanLil Valentin
Jul 1, 2016·BJOG : an International Journal of Obstetrics and Gynaecology·L WynantsB Van Calster
Oct 16, 2016·European Journal of Epidemiology·Kevin Ten Haaf, Ewout Willem Steyerberg
Oct 30, 2016·International Journal of Radiation Oncology, Biology, Physics·Jamie A DeanSarah L Gulliford
Mar 24, 2017·PloS One·Cynthia S CrowsonUNKNOWN A Trans-Atlantic Cardiovascular Risk Consortium for Rheumatoid Arthritis (ATACC-RA)
Mar 24, 2017·Statistical Methods in Medical Research·Ilona Wm VerburgNicolette F de Keizer
Apr 6, 2017·Journal of the American Medical Informatics Association : JAMIA·Sharon E DavisMichael E Matheny
May 2, 2017·PloS One·Antonio Palazón-BruVicente Francisco Gil-Guillén
Nov 21, 2017·Statistics in Medicine·Michael J PencinaRalph B D'Agostino
Sep 21, 2016·Statistical Methods in Medical Research·L WynantsB Van Calster
Jun 6, 2018·European Journal of Cancer Care·Ana Gabriela Jover-EspláVicente Francisco Gil-Guillén
Aug 17, 2018·Human Brain Mapping·Jie YangChristine DeLorenzo
Nov 21, 2017·Journal of the American Heart Association·Benjamin S WesslerDavid M Kent
Sep 17, 2018·Clinical Otolaryngology : Official Journal of ENT-UK ; Official Journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery·David López-BruVicente F Gil-Guillén
Aug 2, 2018·Acta Anaesthesiologica Scandinavica·Anders GranholmMorten Hylander Møller
Sep 29, 2018·Journal of Epidemiology and Community Health·Susanne RospleszczAnnette Peters
Jan 17, 2019·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Kathleen F KerrHolly Janes
Jan 29, 2019·Annals of Internal Medicine·Desiree WusslerChristian Mueller
Feb 5, 2019·Circulation. Cardiovascular Imaging·James J JangUNKNOWN PROMISE Investigators
Feb 9, 2018·Critical Care : the Official Journal of the Critical Care Forum·Anders GranholmMorten Hylander Møller
Mar 3, 2019·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Hongbo LiQuan Wang
Apr 2, 2019·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Qin FuJian-Hua Lin
Apr 30, 2019·European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology·Ana M Martínez-DíazVicente F Gil-Guillén
Aug 8, 2018·BMC Medical Research Methodology·Haifang NiIrene Klugkist
Sep 11, 2019·Journal of the American Medical Informatics Association : JAMIA·Matthew C LenertColin G Walsh
Aug 3, 2017·Annals of Surgical Oncology·James W JakubAmy C Degnim
Oct 24, 2019·JAMA Psychiatry·Seena Fazel, Lauren O'Reilly
Jul 6, 2019·Acta Anaesthesiologica Scandinavica·Anders GranholmMorten Hylander Møller
Jan 21, 2020·Biometrical Journal. Biometrische Zeitschrift·Nora FalconieriLaure Wynants
Oct 22, 2016·Critical Care Medicine·Ilona Willempje Maria VerburgNicolette Fransisca de Keizer
Feb 28, 2020·Journal of the American Medical Informatics Association : JAMIA·Yingxiang HuangLucila Ohno-Machado
Jun 19, 2019·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Daniel J LaneDamon C Scales
Aug 24, 2019·European Journal of Cancer Care·Antonio Palazón-BruMaría Ángeles Carbonell-Torregrosa
Feb 20, 2018·Assessment·Oliver LindhiemEric A Youngstrom

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