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A closed testing procedure to select an appropriate method for updating prediction models.

Yvonne Vergouwe1, Daan Nieboer1, Rianne Oostenbrink2

  • 1Center for Medical Decision Sciences, Department of Public Health, Erasmus MC, Rotterdam, the Netherlands.

Statistics in Medicine
|November 29, 2016
PubMed
Summary

A new closed testing procedure helps select appropriate model updating methods for logistic regression prediction models. This strategy balances updating evidence with overfitting risks, improving model performance in new populations.

Keywords:
closed testing procedurelogistic regressionmodel updatingprediction model

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Area of Science:

  • Biostatistics
  • Clinical Epidemiology

Background:

  • Logistic regression prediction models often perform poorly in populations different from their development sample.
  • Model updating strategies exist but vary in their extensiveness and risk of overfitting.

Purpose of the Study:

  • To define a strategy for selecting appropriate prediction model update methods.
  • To balance the evidence for updating with the risk of overfitting in new patient samples.

Main Methods:

  • Considered recalibration in the large, recalibration, and model revision as update methods.
  • Proposed a closed testing procedure for progressively increasing update extensiveness.
  • Maintained approximate type I error rate through multiple testing.

Main Results:

  • The closed testing procedure selected recalibration in the large for a prostate cancer model, avoiding overfitting seen with full model revision.
  • The procedure demonstrated advantages in traumatic brain injury and pediatric fever examples.
  • The method effectively balanced updating needs and overfitting risks.

Conclusions:

  • The proposed closed testing procedure is a useful tool for selecting appropriate update methods for existing prediction models.
  • This approach can enhance the generalizability and reliability of prediction models across different populations.