Abstract:
OBJECTIVE:To demonstrate how decision analytic models (DAMs) can be used to quantify impact of using a (diagnostic or prognostic) prediction model in clinical practice and provide general guidance on how to perform such assessments. STUDY DESIGN AND SETTING:A DAM was developed to assess the impact of using the HEART score for predicting major adverse cardiac events (MACE). Impact on patient health outcomes and health care costs was assessed in scenarios by varying compliance with and informed deviation (ID) (using additional clinical knowledge) from HEART score management recommendations. Probabilistic sensitivity analysis was used to assess estimated impact robustness. RESULTS:Impact of using the HEART score on health outcomes and health care costs was influenced by an interplay of compliance with and ID from HEART score management recommendations. Compliance of 50% (with 0% ID) resulted in increased missed MACE and costs compared with usual care. Any compliance combined with at least 50% ID reduced both costs and missed MACE. Other scenarios yielded a reduction in missed MACE at higher costs. CONCLUSION:Decision analytic modeling is a useful approach to assess impact of using a prediction model in practice on health outcomes and health care costs. This approach is recommended before conducting an impact trial to improve its design and conduct.
journal_name
J Clin Epidemioljournal_title
Journal of clinical epidemiologyauthors
Jenniskens K,Lagerweij GR,Naaktgeboren CA,Hooft L,Moons KGM,Poldervaart JM,Koffijberg H,Reitsma JBdoi
10.1016/j.jclinepi.2019.07.010subject
Has Abstractpub_date
2019-11-01 00:00:00pages
106-115eissn
0895-4356issn
1878-5921pii
S0895-4356(19)30053-8journal_volume
115pub_type
杂志文章abstract:OBJECTIVE:To evaluate the mechanisms of action in two successful geriatric clinical trials that tested multicomponent physical conditioning programs and to determine whether the pathways for overall benefit were through improvement in physical ability and/or self-confidence. STUDY DESIGN AND SETTING:PREHAB and DRIVER ...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinepi.2006.04.009
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVE:Estimates of minimal clinically important improvements (MCIIs) are larger among patients with higher values at baseline, suggesting that these patients require larger changes to appreciate improvements. We examined if baseline dependency of MCIIs was associated with specific patients across three measures, or...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2013.10.025
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Psychometrically sound questionnaires for the assessment of vision-related quality of life (QOL) are scarce. Therefore, the objective was to further validate two vision-related QOL questionnaires in a Dutch population of visually impaired elderly. METHODS:A total of 329 visually impaired older...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2005.04.007
更新日期:2005-12-01 00:00:00
abstract::The objective of this study was to assess the discriminative properties of the methods for diagnosing acute maxillary sinusitis (AMS) in unselected patients. The study design was a systematic review of evaluation studies identified by using Medline, by searching reference lists, by hand searches, and by contacting inv...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,meta分析
doi:10.1016/s0895-4356(99)00213-9
更新日期:2000-09-01 00:00:00
abstract:OBJECTIVE:Both randomized and observational studies commonly examine composite end points, but the literature on model development and criticism in this setting is limited. STUDY DESIGN AND SETTING:We examined approaches for evaluating heterogeneity in the effects of risk factors for different components of the end po...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2003.02.001
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVES:To identify, describe, and map contemporary nutrition guidelines (NGs) from reviews that used the Appraisal of Guidelines, Research and Evaluation (AGREE) tool. STUDY DESIGN AND SETTING:We performed an overview of reviews that systematically assessed the quality of NGs using the AGREE tool. We searched MEDL...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2018.08.018
更新日期:2018-12-01 00:00:00
abstract::The present paper analyses the epidemiologic effects of mass breast cancer screening. Mass mammography may possibly achieve a breast cancer mortality reduction in relative risk terms. However, this does not necessarily represent a net benefit. It is argued that the benefits and adverse effects of a screening programme...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/0895-4356(90)90002-7
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVES:The objective of the study is to examine the time from publication of the protocol for a Cochrane review to publication of the Cochrane review for the entire Cochrane Database of Systematic Reviews (CDSR). STUDY DESIGN AND SETTINGS:Cochrane reviews from the CDSR published between 1995 and 2019 were assessed...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2020.05.011
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVES:To explore user perspectives on applying the Grading of Recommendations Assessment, Development and Evaluation (GRADE) to systematic reviews of complex interventions. STUDY DESIGN AND SETTING:Thirty-three authors of recent (2013 onward) systematic reviews were contacted regarding their perspectives on using...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2015.09.010
更新日期:2016-02-01 00:00:00
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journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2016.07.002
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVE:The Work Instability Scale for Rheumatoid Arthritis (RA-WIS) is a promising prognostic tool for future work disability outcomes. Rasch analysis was conducted to examine the psychometric performance of the RA-WIS in work-related upper limb disorders. STUDY DESIGN AND SETTING:Eligible injured workers (n=396) a...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2011.02.002
更新日期:2011-11-01 00:00:00
abstract::We review methods for the analysis of categorical clinical and epidemiological data, in which the observations are subject to misclassification. Under certain conditions, it is possible to estimate error parameters such as sensitivity, specificity, relative risk, or predictive value, even though no definitive classifi...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/0895-4356(88)90110-2
更新日期:1988-01-01 00:00:00
abstract::Biologic studies have suggested that antidepressant use may increase breast cancer risk. We conducted a systematic review of trials and controlled epidemiologic studies to assess this association. Pooled data from 31 primary efficacy drug company trials of fluoxetine suggested no increased risk but the short duration ...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/s0895-4356(02)00568-1
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVE:To describe the process of development, content, and methods of implementation of reporting guidelines for health research. STUDY DESIGN AND SETTING:A systematic review of publications describing health research reporting guidelines developed using consensus. RESULTS:Eighty-one reporting guidelines for heal...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2010.09.013
更新日期:2011-07-01 00:00:00
abstract::In middle-aged people, social class is one of the strongest predictors of mortality. However, to date, research prospectively evaluating the relationship between social class and mortality in the older persons has produced conflicting results. This may be due to the lack of clinical covariates in many analyses. The ob...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(02)00464-x
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVE:To investigate the behavior of predictive performance measures that are commonly used in external validation of prognostic models for outcome at intensive care units (ICUs). STUDY DESIGN AND SETTING:Four prognostic models (Simplified Acute Physiology Score II, the Acute Physiology and Chronic Health Evaluati...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2006.08.011
更新日期:2007-05-01 00:00:00
abstract::With advances made in the treatment of people with HIV/AIDS, there is an increasing number of persons who are reaching old age. This is a heterogeneous group. Yet, all of these diverse patients share in common the challenge of aging successfully despite their condition. There is little room in most gerontological conc...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/s0895-4356(01)00447-4
更新日期:2001-12-01 00:00:00
abstract::Moderate consumers of alcohol have lower mortality than either nondrinkers or heavy drinkers. This systematic review aimed to quantify the level of alcohol consumption (termed the nadir) at which the lowest mortality occurs. Twenty cohort studies reported analyses of all-cause mortality for at least three categories o...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,meta分析
doi:10.1016/s0895-4356(99)00076-1
更新日期:1999-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Two methods for measuring insulin sensitivity, fasting plasma insulin (FPI) and homeostasis model assessment (HOMA) have been proposed for use in large epidemiological research and clinical practice. This project describes the range of observed values of the HOMA and FPI in a large sample of th...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2004.05.001
更新日期:2004-11-01 00:00:00
abstract::Numerous studies have shown that the symptoms of angina pectoris are more prevalent in women than men, than other manifestations of coronary heart disease, with the greatest discrepancies at younger ages. Variation in symptom reliability between genders could be a potential explanation for these differences. The Lipid...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(91)90009-x
更新日期:1991-01-01 00:00:00
abstract::The objective of this study was to assess the effects of a multicomponent intervention on private pharmacy practice. From 641 private pharmacies in Hanoi, 68 pharmacies were randomly selected and matched into 34 pairs. Each pair consisted of a control and an intervention pharmacy. Three interventions were applied sequ...
journal_title:Journal of clinical epidemiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0895-4356(02)00458-4
更新日期:2002-11-01 00:00:00
abstract:OBJECTIVE:Graphical methods for generating explanatory hypotheses from limited categorical data are described and illustrated. STUDY DESIGN AND SETTING:Univariate, bivariate, multivariate, and multiplicative graphical methods were applied to clinical data regarding very ill older persons. The data to which these metho...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2011.06.007
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:Exposure to ultraviolet radiation has consistently been linked to an increased risk of melanoma. Epidemiologic studies are susceptible to measurement error, which can distort the magnitude of observed effects. Although the reliability of self-report of many sun exposure factors has been previously described i...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2004.09.004
更新日期:2005-04-01 00:00:00
abstract::Medicine has been dominated by uncontrolled data, often of unproven validity and insufficient to answer clinically important questions pertaining to individual patients. Controlled clinical trials, when designed and conducted rigorously, offer advantages over uncontrolled data, but they cannot be done for everything a...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(98)00042-0
更新日期:1998-08-01 00:00:00
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journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2003.07.001
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to evaluate how frequently complex interventions are shown to be superior to routine care in general practice-based cluster-randomized controlled studies (c-RCTs) and to explore whether potential differences explain results that come out in favor of a complex intervention. STUDY DE...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2017.10.010
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:To estimate the effect of weight-loss interventions on health-related quality of life (HrQoL) in randomized controlled trials (RCTs); to conduct a meta-analysis of weight-loss treatment on depressive symptoms; and, to examine methodological and presentation issues that compromise study validity. STUDY DESIGN...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jclinepi.2004.10.015
更新日期:2005-06-01 00:00:00
abstract:BACKGROUND:The probability of a disease, given the result of two diagnostic tests, can be calculated by multiplying the odds of disease after the first test by the likelihood ratio of the second test. OBJECTIVE:To illustrate the error that occurs when calculating disease probability by combining the results of tests t...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2009.04.010
更新日期:2009-12-01 00:00:00
abstract::The objective of this study was to construct a prediction model for predicting stroke in an elderly U.S. population, and to assess the accuracy in this population of other previously published prediction models. The subjects were participants in the Cardiovascular Health Study: 2,495 men and 3,393 women age 65 years a...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(01)00434-6
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVES:Calibration is often thought to assess the bias of a clinical prediction rule. In particular, if the rule is based on a linear logistic model, it is often assumed that an overestimation of all coefficients results in a calibration slope less than 1 and an underestimation in a slope larger than 1. STUDY DESI...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2013.06.003
更新日期:2013-11-01 00:00:00