Assessing New Biomarkers and Predictive Models for Use in Clinical Practice A Clinician's Guide
Assessing New Biomarkers and Predictive Models for Use in Clinical Practice A Clinician's Guide
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DOI：
10.1001/archinte.168.21.2304
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发表时间：
2008-11-24
影响因子：
--
通讯作者：
Wong, Tien Y.
中科院分区：
文献类型：
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作者：
McGeechan, Kevin;Macaskill, Petra;Wong, Tien Y.
新的生物标志物和预测模型，旨在提高心血管疾病风险的人的识别不断提出。临床医生需要了解用于评估这些生物标志物和模型的各种方法以及应如何解释这些方法。新的生物标志物和模型根据其对全局拟合、区分、校准和重新分类的贡献进行评估。当单独使用时，这些措施并不能解决临床上重要的问题，即新模型是否比现有模型更准确地预测风险，以及预测的个体风险是否有足够的差异来保证治疗决策的改变。我们建议用图形显示补充这些测量，例如Hosmer-Lemeshow检验的校准图和比较模型预测风险的散点图。我们鼓励研究人员报告新生物标志物临床效用研究中的此类分析，因为这些信息与临床医生相关，临床医生必须决定是否在临床实践中测试新生物标志物。《内科学文献》2008; 168（21）：2304-2310
New biomarkers and predictive models that aim to improve the identification of people at risk of cardiovascular disease are constantly proposed. Clinicians need to be aware of the various methods used to assess these biomarkers and models and how these should be interpreted. New biomarkers and models are assessed in terms of their contribution to global fit, discrimination, calibration, and reclassification. These measures, when used in isolation, do not address the clinically important questions of whether the new model predicts risk more accurately than existing models and whether the risks predicted for individuals are sufficiently different to warrant a change in treatment decisions. We recommend that these measures be supplemented with graphical displays such as a calibration plot for the Hosmer-Lemeshow test and a scatterplot of the risks predicted by the models being compared. We encourage researchers to report such analyses from studies on the clinical utility of new biomarkers because this information is pertinent for the clinician who must decide whether to test for a new biomarker in their clinical practice. Arch Intern Med. 2008; 168( 21): 2304-2310