Extensions of net reclassification improvement calculations to measure usefulness of new biomarkers.

Appropriate quantification of added usefulness offered by new markers included in risk prediction algorithms is a problem of active research and debate. Standard methods, including statistical significance and c statistic are useful but not sufficient. Net reclassification improvement (NRI) offers a...

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Publicado en:Statistics in Medicine Vol. 30; no. 1; pp. 11 - 22
Autores principales: Pencina MJ, D'Agostino RB Sr, Steyerberg EW, Pencina, Michael J, D'Agostino, Ralph B Sr, Steyerberg, Ewout W
Formato: research Journal Article
Publicado: Wiley-Blackwell Jan2011
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Extensions of net reclassification improvement calculations to measure usefulness of new biomarkers.
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          Pencina MJ
          D'Agostino RB Sr
          Steyerberg EW
          Pencina, Michael J
          D'Agostino, Ralph B Sr
          Steyerberg, Ewout W
        affil: Department of Biostatistics, Boston University, 801 Massachusetts Ave, Boston, MA 02118, USA
      sug:
        subj:
          Biological Markers Analysis
          Models, Biological
          Models, Statistical
          Risk Assessment Methods
          Adult
          Aged
          Case Control Studies
          Coronary Disease Epidemiology
          Coronary Disease Metabolism
          Female
          Human
          Kaplan-Meier Estimator
          Prospective Studies
          Male
          Middle Age
          Adult: 19-44 years
          Aged: 65+ years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Appropriate quantification of added usefulness offered by new markers included in risk prediction algorithms is a problem of active research and debate. Standard methods, including statistical significance and c statistic are useful but not sufficient. Net reclassification improvement (NRI) offers a simple intuitive way of quantifying improvement offered by new markers and has been gaining popularity among researchers. However, several aspects of the NRI have not been studied in sufficient detail. In this paper we propose a prospective formulation for the NRI which offers immediate application to survival and competing risk data as well as allows for easy weighting with observed or perceived costs. We address the issue of the number and choice of categories and their impact on NRI. We contrast category-based NRI with one which is category-free and conclude that NRIs cannot be compared across studies unless they are defined in the same manner. We discuss the impact of differing event rates when models are applied to different samples or definitions of events and durations of follow-up vary between studies. We also show how NRI can be applied to case-control data. The concepts presented in the paper are illustrated in a Framingham Heart Study example. In conclusion, NRI can be readily calculated for survival, competing risk, and case-control data, is more objective and comparable across studies using the category-free version, and can include relative costs for classifications. We recommend that researchers clearly define and justify the choices they make when choosing NRI for their application.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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