Journal
JOURNAL OF THE ROYAL STATISTICAL SOCIETY SERIES A-STATISTICS IN SOCIETY
Volume 172, Issue -, Pages 729-748Publisher
WILEY
DOI: 10.1111/j.1467-985X.2009.00592.x
Keywords
Decision analysis; Decision curve; Receiver operating characteristic curve; Utility
Funding
- Donald W. Reynolds Foundation (Las Vegas, Nevada)
- National Heart, Lung and Blood Institute [HL043851, CA047988]
- National Cancer Institute
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Because many medical decisions are based on risk prediction models that are constructed from medical history and results of tests, the evaluation of these prediction models is important. This paper makes five contributions to this evaluation: the relative utility curve which gauges the potential for better prediction in terms of utilities, without the need for a reference level for one utility, while providing a sensitivity analysis for misspecification of utilities, the relevant region, which is the set of values of prediction performance that are consistent with the recommended treatment status in the absence of prediction, the test threshold, which is the minimum number of tests that would be traded for a true positive prediction in order for the expected utility to be non-negative, the evaluation of two-stage predictions that reduce test costs and connections between various measures of performance of prediction. An application involving the risk of cardiovascular disease is discussed.
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