Evaluating disease prediction models using a cohort whose covariate distribution differs from that of the target population.

Personal predictive models for disease development play important roles in chronic disease prevention. The performance of these models is evaluated by applying them to the baseline covariates of participants in external cohort studies, with model predictions compared to subjects' subsequent disease...

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Published in:Statistical Methods in Medical Research Vol. 28; no. 1; pp. 309 - 321
Main Authors: Powers, Scott, McGuire, Valerie, Bernstein, Leslie, Canchola, Alison J., Whittemore, Alice S.
Format: research Journal Article
Published: Sage Publications Inc. Jan2019
Online Access:View this record in EBSCOhost
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      dt: Jan2019
      vid: 28
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: Evaluating disease prediction models using a cohort whose covariate distribution differs from that of the target population.
      aug:
        au:
          Powers, Scott
          McGuire, Valerie
          Bernstein, Leslie
          Canchola, Alison J.
          Whittemore, Alice S.
        affil: Department of Statistics, Stanford University, Stanford, CA, USA
      sug:
        subj:
          Models, Statistical
          Prospective Studies
          Epidemiology
          Young Adult
          Ovarian Neoplasms Etiology
          Ovarian Neoplasms Epidemiology
          Human
          Female
          Adult
          Calibration
          Selection Bias
          Surveys
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Adult: 19-44 years
          Female
      ab: Personal predictive models for disease development play important roles in chronic disease prevention. The performance of these models is evaluated by applying them to the baseline covariates of participants in external cohort studies, with model predictions compared to subjects' subsequent disease incidence. However, the covariate distribution among participants in a validation cohort may differ from that of the population for which the model will be used. Since estimates of predictive model performance depend on the distribution of covariates among the subjects to which it is applied, such differences can cause misleading estimates of model performance in the target population. We propose a method for addressing this problem by weighting the cohort subjects to make their covariate distribution better match that of the target population. Simulations show that the method provides accurate estimates of model performance in the target population, while un-weighted estimates may not. We illustrate the method by applying it to evaluate an ovarian cancer prediction model targeted to US women, using cohort data from participants in the California Teachers Study. The methods can be implemented using open-source code for public use as the R-package RMAP (Risk Model Assessment Package) available at http://stanford.edu/~ggong/rmap/ .
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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