A Systematic Review of the Literature Demonstrates Some Errors in the Use of Decision Curve Analysis but Generally Correct Interpretation of Findings

Medical Decision Making : an International Journal of the Society for Medical Decision Making
Paolo Capogrosso, Andrew J Vickers

Abstract

Background. Decision curve analysis (DCA) is a widely used methodology in clinical research studies. Purpose. We performed a literature review to identify common errors in the application of DCA and provide practical suggestions for appropriate use of DCA. Data Sources. We first conducted an informal literature review and identified 6 errors found in some DCAs. We then used Google Scholar to conduct a systematic review of studies applying DCA to evaluate a predictive model, marker, or test. Data Extraction. We used a standard data collection form to collect data for each reviewed article. Data Synthesis. Each article was assessed according to the 6 predefined criteria for a proper analysis, reporting, and interpretation of DCA. Overall, 50 articles were included in the review: 54% did not select an appropriate range of probability thresholds for the x-axis of the DCA, with a similar proportion (50%) failing to present smoothed curves. Among studies with internal validation of a predictive model and correction for overfit, 61% did not clearly report whether the DCA had also been corrected. However, almost all studies correctly interpreted the DCA, used a correct outcome (92% for both), and clearly reported the clinical decision ...Continue Reading

References

Mar 1, 2000·Statistics in Medicine·D G Altman, P Royston
May 17, 2000·Health Affairs·D Shactman, S H Altman
Nov 14, 2006·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Andrew J Vickers, Elena B Elkin
Feb 12, 2008·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Ewout W Steyerberg, Andrew J Vickers
Nov 28, 2008·BMC Medical Informatics and Decision Making·Andrew J VickersMithat Gonen
Aug 23, 2012·Annals of Internal Medicine·A Russell Localio, Steven Goodman
Jan 28, 2015·JAMA : the Journal of the American Medical Association·Mark FitzgeraldRoger J Lewis
Jan 27, 2016·BMJ : British Medical Journal·Andrew J VickersEwout W Steyerberg
Jun 2, 2016·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Kathleen F KerrHolly Janes

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Citations

May 21, 2019·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Kathleen F KerrHolly Janes
Oct 23, 2020·Clinical Otolaryngology : Official Journal of ENT-UK ; Official Journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery·Mayke A HentschelHenricus P M Kunst
Mar 7, 2021·The Spine Journal : Official Journal of the North American Spine Society·Andrew J Vickers, Ford Holland
Apr 5, 2021·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Mayke HentschelHenricus Kunst
Aug 8, 2021·European Urology Focus·Jethro C C KwongGirish S Kulkarni

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Methods Mentioned

BETA
biopsy

Software Mentioned

DCA
Google Scholar

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