Assessing risk prediction models using individual participant data from multiple studies.
Assessing risk prediction models using individual participant data from multiple studies.
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DOI：
10.1093/aje/kwt298
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发表时间：
2014-03-01
影响因子：
5
通讯作者：
Emerging Risk Factors Collaboration
中科院分区：
文献类型：
--
作者：
Pennells L;Kaptoge S;White IR;Thompson SG;Wood AM;Emerging Risk Factors Collaboration
来自多个前瞻性流行病学研究的个体参与者至事件发生时间数据使得能够对风险模型的预测能力进行详细调查。在这里，我们解决的挑战，在适当地结合这些信息的研究。方法通过分析log C-反应蛋白和新兴风险因素协作组中冠心病的常规风险因素来举例说明，该协作组整理了来自多项前瞻性研究的个体数据，平均随访时间为9.8年（日期不同）。我们推导出风险预测模型，使用考克斯比例风险回归分析分层的研究，并获得估计的风险歧视，Harrell的一致性指数，和Royston的歧视措施在每个研究中，然后我们联合收割机的估计跨研究使用加权荟萃分析。各种加权方法进行了比较，并导致我们建议在每个研究中使用的事件数。我们还讨论了多项研究的重新分类措施的计算。我们进一步表明，在亚组之间的预测能力的差异比较应仅基于研究内的信息，并结合从病例对照研究和前瞻性研究的风险区分措施是有问题的。的一致性指数和歧视措施，在整个定性相似的结果。虽然研究之间的一致性指数非常不均匀，主要是因为不同的年龄范围，增加log C反应蛋白的一致性指数的增量是更均匀的传统的危险因素。
Individual participant time-to-event data from multiple prospective epidemiologic studies enable detailed investigation into the predictive ability of risk models. Here we address the challenges in appropriately combining such information across studies. Methods are exemplified by analyses of log C-reactive protein and conventional risk factors for coronary heart disease in the Emerging Risk Factors Collaboration, a collation of individual data from multiple prospective studies with an average follow-up duration of 9.8 years (dates varied). We derive risk prediction models using Cox proportional hazards regression analysis stratified by study and obtain estimates of risk discrimination, Harrell's concordance index, and Royston's discrimination measure within each study; we then combine the estimates across studies using a weighted meta-analysis. Various weighting approaches are compared and lead us to recommend using the number of events in each study. We also discuss the calculation of measures of reclassification for multiple studies. We further show that comparison of differences in predictive ability across subgroups should be based only on within-study information and that combining measures of risk discrimination from case-control studies and prospective studies is problematic. The concordance index and discrimination measure gave qualitatively similar results throughout. While the concordance index was very heterogeneous between studies, principally because of differing age ranges, the increments in the concordance index from adding log C-reactive protein to conventional risk factors were more homogeneous.
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影响因子：
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作者：
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通讯作者：
Steyerberg, Ewout W.
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通讯作者：
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通讯作者：
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