Multiple Score Comparison: a network meta-analysis approach to comparison and external validation of prognostic scores

BACKGROUND: Prediction models and prognostic scores have been increasingly popular in both clinical practice and clinical research settings, for example to aid in risk-based decision making or control for confounding. In many medical fields, a large number of prognostic scores are available, but pra...

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Autores: Haile, Sarah R., García Aymerich, Judith, Antó i Boqué, Josep Maria, Puhan, Milo A., Crystal structure of cold-aminopeptidase from Colwellia psychrerythraea (3CIA) collaborators
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2017
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/34254
Acceso en línea:http://hdl.handle.net/10230/34254
http://dx.doi.org/10.1186/s12874-017-0433-2
Access Level:acceso abierto
Palabra clave:Prognostic scores
External validation
Multiple score comparison
Chronic obstructive pulmonary disease
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spelling Multiple Score Comparison: a network meta-analysis approach to comparison and external validation of prognostic scoresHaile, Sarah R.García Aymerich, JudithAntó i Boqué, Josep MariaPuhan, Milo A.Crystal structure of cold-aminopeptidase from Colwellia psychrerythraea (3CIA) collaboratorsPrognostic scoresExternal validationMultiple score comparisonChronic obstructive pulmonary diseaseBACKGROUND: Prediction models and prognostic scores have been increasingly popular in both clinical practice and clinical research settings, for example to aid in risk-based decision making or control for confounding. In many medical fields, a large number of prognostic scores are available, but practitioners may find it difficult to choose between them due to lack of external validation as well as lack of comparisons between them. METHODS: Borrowing methodology from network meta-analysis, we describe an approach to Multiple Score Comparison meta-analysis (MSC) which permits concurrent external validation and comparisons of prognostic scores using individual patient data (IPD) arising from a large-scale international collaboration. We describe the challenges in adapting network meta-analysis to the MSC setting, for instance the need to explicitly include correlations between the scores on a cohort level, and how to deal with many multi-score studies. We propose first using IPD to make cohort-level aggregate discrimination or calibration scores, comparing all to a common comparator. Then, standard network meta-analysis techniques can be applied, taking care to consider correlation structures in cohorts with multiple scores. Transitivity, consistency and heterogeneity are also examined. RESULTS: We provide a clinical application, comparing prognostic scores for 3-year mortality in patients with chronic obstructive pulmonary disease using data from a large-scale collaborative initiative. We focus on the discriminative properties of the prognostic scores. Our results show clear differences in performance, with ADO and eBODE showing higher discrimination with respect to mortality than other considered scores. The assumptions of transitivity and local and global consistency were not violated. Heterogeneity was small. CONCLUSIONS: We applied a network meta-analytic methodology to externally validate and concurrently compare the prognostic properties of clinical scores. Our large-scale external validation indicates that the scores with the best discriminative properties to predict 3 year mortality in patients with COPD are ADO and eBODE.BioMed Central201820182017info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/34254http://dx.doi.org/10.1186/s12874-017-0433-2reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésAnuncis BMC Medical Research Methodology. 2017 Dec 21;17(1):172© The Author(s). 2017 Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/342542026-06-12T07:21:37Z
dc.title.none.fl_str_mv Multiple Score Comparison: a network meta-analysis approach to comparison and external validation of prognostic scores
title Multiple Score Comparison: a network meta-analysis approach to comparison and external validation of prognostic scores
spellingShingle Multiple Score Comparison: a network meta-analysis approach to comparison and external validation of prognostic scores
Haile, Sarah R.
Prognostic scores
External validation
Multiple score comparison
Chronic obstructive pulmonary disease
title_short Multiple Score Comparison: a network meta-analysis approach to comparison and external validation of prognostic scores
title_full Multiple Score Comparison: a network meta-analysis approach to comparison and external validation of prognostic scores
title_fullStr Multiple Score Comparison: a network meta-analysis approach to comparison and external validation of prognostic scores
title_full_unstemmed Multiple Score Comparison: a network meta-analysis approach to comparison and external validation of prognostic scores
title_sort Multiple Score Comparison: a network meta-analysis approach to comparison and external validation of prognostic scores
dc.creator.none.fl_str_mv Haile, Sarah R.
García Aymerich, Judith
Antó i Boqué, Josep Maria
Puhan, Milo A.
Crystal structure of cold-aminopeptidase from Colwellia psychrerythraea (3CIA) collaborators
author Haile, Sarah R.
author_facet Haile, Sarah R.
García Aymerich, Judith
Antó i Boqué, Josep Maria
Puhan, Milo A.
Crystal structure of cold-aminopeptidase from Colwellia psychrerythraea (3CIA) collaborators
author_role author
author2 García Aymerich, Judith
Antó i Boqué, Josep Maria
Puhan, Milo A.
Crystal structure of cold-aminopeptidase from Colwellia psychrerythraea (3CIA) collaborators
author2_role author
author
author
author
dc.subject.none.fl_str_mv Prognostic scores
External validation
Multiple score comparison
Chronic obstructive pulmonary disease
topic Prognostic scores
External validation
Multiple score comparison
Chronic obstructive pulmonary disease
description BACKGROUND: Prediction models and prognostic scores have been increasingly popular in both clinical practice and clinical research settings, for example to aid in risk-based decision making or control for confounding. In many medical fields, a large number of prognostic scores are available, but practitioners may find it difficult to choose between them due to lack of external validation as well as lack of comparisons between them. METHODS: Borrowing methodology from network meta-analysis, we describe an approach to Multiple Score Comparison meta-analysis (MSC) which permits concurrent external validation and comparisons of prognostic scores using individual patient data (IPD) arising from a large-scale international collaboration. We describe the challenges in adapting network meta-analysis to the MSC setting, for instance the need to explicitly include correlations between the scores on a cohort level, and how to deal with many multi-score studies. We propose first using IPD to make cohort-level aggregate discrimination or calibration scores, comparing all to a common comparator. Then, standard network meta-analysis techniques can be applied, taking care to consider correlation structures in cohorts with multiple scores. Transitivity, consistency and heterogeneity are also examined. RESULTS: We provide a clinical application, comparing prognostic scores for 3-year mortality in patients with chronic obstructive pulmonary disease using data from a large-scale collaborative initiative. We focus on the discriminative properties of the prognostic scores. Our results show clear differences in performance, with ADO and eBODE showing higher discrimination with respect to mortality than other considered scores. The assumptions of transitivity and local and global consistency were not violated. Heterogeneity was small. CONCLUSIONS: We applied a network meta-analytic methodology to externally validate and concurrently compare the prognostic properties of clinical scores. Our large-scale external validation indicates that the scores with the best discriminative properties to predict 3 year mortality in patients with COPD are ADO and eBODE.
publishDate 2017
dc.date.none.fl_str_mv 2017
2018
2018
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/34254
http://dx.doi.org/10.1186/s12874-017-0433-2
url http://hdl.handle.net/10230/34254
http://dx.doi.org/10.1186/s12874-017-0433-2
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Anuncis BMC Medical Research Methodology. 2017 Dec 21;17(1):172
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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