Prognosis and prognostic research validating a prognostic model

Schematic representation of diagnostic and prognostic prediction modeling studies.The nature of the prediction in diagnosis is estimating the probability that a specific outcome or disease is present (or absent) within an individual, at this point in time—that is, the moment of prediction (T = 0).An extensive list of items based on a review of the literature was created, which was reduced after a Web-based survey and revised during a 3-day meeting in June 2011 with methodologists, health care professionals, and journal editors.

External validation may use participant data collected by the same investigators, typically using the same predictor and outcome definitions and measurements, but sampled from a later period (temporal or narrow validation); by other investigators in another hospital or country, sometimes using different definitions and measurements (geographic or broad validation); in similar participants but from an intentionally different setting (for example, model developed in secondary care and assessed in similar participants but selected from primary care); or even in other types of participants (for example, model developed in adults and assessed in children, or developed for predicting fatal events and assessed for predicting nonfatal events) (13, 15, 17, 21, 22).From Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, United Kingdom, and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.Prediction models are developed to aid health care providers in estimating the probability or risk that a specific disease or condition is present (diagnostic models) or that a specific event will occur in the future (prognostic models), to inform their decision making.The resulting TRIPOD Statement is a checklist of 22 items, deemed essential for transparent reporting of a prediction model study.The TRIPOD Statement aims to improve the transparency of the reporting of a prediction model study regardless of the study methods used.

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