Decision Curve Analysis

Fitzgerald, Mark; Saville, Benjamin R.; Lewis, Roger J.

doi:10.1001/jama.2015.37

Cited by 512 publications

(431 citation statements)

References 6 publications

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“…Lastly, decision curve analyses were performed in order to estimate the range of threshold probabilities in which VTE‐BLEED may provide a net benefit over standard management considering only major bleeding events (Fitzgerald et al , 2015; Klok et al , 2017). The assumptions included treatment according to VTE‐BLEED works better than two extreme scenarios, considering that ‘all’ or ‘none of’ patients are treated, and assuming that anticoagulation in patients classified in the high‐risk VTE‐BLEED group will be discontinued.…”

Section: Methodsmentioning

confidence: 99%

Predictive value of venous thromboembolism (VTE)‐BLEED to predict major bleeding and other adverse events in a practice‐based cohort of patients with VTE: results of the XALIA study

et al. 2018

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SummaryVenous thromboembolism (VTE)‐BLEED, a decision tool for predicting major bleeding during chronic anticoagulation for VTE has not yet been validated in practice‐based conditions. We calculated the prognostic indices of VTE‐BLEED for major bleeding after day 30 and day 90, as well as for recurrent VTE and all‐cause mortality, in 4457 patients enrolled in the international, prospective XALIA study. The median at‐risk time was 190 days (interquartile range 106–360). The crude hazard ratio (HR) for major bleeding after day 30 was 2·6 [95% confidence interval (CI) 1·3–5·2] and the treatment‐adjusted HR was 2·3 (95% CI 1·1–4·5) for VTE‐BLEED high (versus low) risk patients: the corresponding values for major bleeding after day 90 were 3·8 (95% CI 1·6–9·3) and 3·2 (95% CI 1·3–7·7), respectively. The predictive value of VTE‐BLEED was similar in selected patients with unprovoked VTE or those treated with rivaroxaban. High VTE‐BLEED score was associated with higher incidence of all‐cause mortality (treatment‐adjusted HR 11, 95% CI 4·8–23), but not evidently with recurrent VTE (treatment‐adjusted HR 1·5; 95% CI 0·85–2·7). These results confirm the predictive value of VTE‐BLEED in practice‐based data in patients treated with rivaroxaban or conventional anticoagulation, supporting the hypothesis that VTE‐BLEED may be useful for making management decisions on the duration of anticoagulant therapy.

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Section: Methodsmentioning

confidence: 99%

Predictive value of venous thromboembolism (VTE)‐BLEED to predict major bleeding and other adverse events in a practice‐based cohort of patients with VTE: results of the XALIA study

et al. 2018

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“…Due to the numerous factors that affect outcomes, such studies, when performed prior to empirical use, are complex and often utilize modeling estimates to estimate the magnitude of clinical impact. The decision curve analysis (DCA) method offers a visual depiction of the net benefit of a test (y-axis) in influencing clinical decisions across a range of theoretical threshold probabilities for intervention (x-axis) [10,11]. Such approaches offer insights into the proposed advantages of a particular tool in various clinical situations.…”

Section: Evaluating Clinical Utilitymentioning

confidence: 99%

Clinical Utility of Biomarkers in Localized Prostate Cancer

2016

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A new generation of prostate cancer (PCa) biomarkers has emerged, including diagnostic serum and urine markers aimed at refining the identification high-grade tumors and tissue-based gene expression assays offering prognostic and predictive clinical information. Such tests seek to improve treatment-related decisions at multiple decision points, including initial diagnosis and following initial primary therapy. In this review, we aim to contextualize the body of evidence surrounding these emerging tests, with attention on studies addressing clinical utility.

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“…The generation of these estimates enables the nomogram to be tailored to the personalized profile of a patient (2). Dr Aviram and colleagues reported a good predicting performance of their constructed model; however, the traditional biostatistical methods they used for evaluating models focus solely on accuracy, calibration, and discrimination using metrics such as sensitivity, specificity, or area under the receiver operating characteristic curve (AUC).…”

Section: Editormentioning

confidence: 99%

“…Dr Huang and colleagues claim that the biostatistical model used should have been based on DCA (2). DCA is a method for evaluating the benefits of a diagnostic test that incorporates clinical consequences of under-or overtreatment (2,3).…”

Section: Disclosures Of Conflicts Ofmentioning

confidence: 99%