Developing points-based risk-scoring systems in the presence of competing risks.
Developing points-based risk-scoring systems in the presence of competing risks.
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DOI：
10.1002/sim.6994
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发表时间：
2016-09-30
影响因子：
2
通讯作者：
Fine, Jason P.
中科院分区：
文献类型：
--
作者：
Austin, Peter C.;Lee, Douglas S.;D'Agostino, Ralph B.;Fine, Jason P.
关键词：
预测不良事件随时间的发生是临床医学中的重要问题。临床预测模型和相关的基于积分的风险评分系统是用于总结多变量患者风险因素集与不良事件发生风险之间关系的常用统计方法。基于积分的风险评分系统在医生中很受欢迎，因为它们允许在不使用计算机或其他电子设备的情况下快速评估患者风险。使用这种基于积分的风险评分系统有助于基于证据的临床决策。人们越来越关注特定原因死亡率和非致命性结局。然而，在考虑这些类型的结果时，必须考虑到其发生会排除关注事件发生的竞争风险。我们描述了如何基于点的风险评分系统可以在竞争事件的存在下开发。我们通过开发风险评分系统来说明这些方法的应用，以预测急性心肌梗死住院患者的心血管死亡率。提供了R统计编程语言的代码用于实现所描述的方法。版权所有2016作者.由John Wiley & Sons Ltd.出版。
Predicting the occurrence of an adverse event over time is an important issue in clinical medicine. Clinical prediction models and associated points‐based risk‐scoring systems are popular statistical methods for summarizing the relationship between a multivariable set of patient risk factors and the risk of the occurrence of an adverse event. Points‐based risk‐scoring systems are popular amongst physicians as they permit a rapid assessment of patient risk without the use of computers or other electronic devices. The use of such points‐based risk‐scoring systems facilitates evidence‐based clinical decision making. There is a growing interest in cause‐specific mortality and in non‐fatal outcomes. However, when considering these types of outcomes, one must account for competing risks whose occurrence precludes the occurrence of the event of interest. We describe how points‐based risk‐scoring systems can be developed in the presence of competing events. We illustrate the application of these methods by developing risk‐scoring systems for predicting cardiovascular mortality in patients hospitalized with acute myocardial infarction. Code in the R statistical programming language is provided for the implementation of the described methods. © 2016 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd.
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