Large-scale external validation and comparison of prognostic models: an application to chronic obstructive pulmonary disease

BMC Medicine
Beniamino Guerra3CIA collaboration

Abstract

External validations and comparisons of prognostic models or scores are a prerequisite for their use in routine clinical care but are lacking in most medical fields including chronic obstructive pulmonary disease (COPD). Our aim was to externally validate and concurrently compare prognostic scores for 3-year all-cause mortality in mostly multimorbid patients with COPD. We relied on 24 cohort studies of the COPD Cohorts Collaborative International Assessment consortium, corresponding to primary, secondary, and tertiary care in Europe, the Americas, and Japan. These studies include globally 15,762 patients with COPD (1871 deaths and 42,203 person years of follow-up). We used network meta-analysis adapted to multiple score comparison (MSC), following a frequentist two-stage approach; thus, we were able to compare all scores in a single analytical framework accounting for correlations among scores within cohorts. We assessed transitivity, heterogeneity, and inconsistency and provided a performance ranking of the prognostic scores. Depending on data availability, between two and nine prognostic scores could be calculated for each cohort. The BODE score (body mass index, airflow obstruction, dyspnea, and exercise capacity) had a medi...Continue Reading

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Citations

Feb 27, 2019·JAMA : the Journal of the American Medical Association·Craig M Riley, Frank C Sciurba
Jul 22, 2020·PloS One·Steven J KiddleJennifer K Quint
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Sep 8, 2020·Chest·Alexander M Matheson, Grace Parraga
Jun 24, 2021·Journal of the American Geriatrics Society·Aaron A Kuntz, Timothy R Holden

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Software Mentioned

R
SAFE
BODE
AE
R Code for
BODEx
MSC
ADO
DOSE

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