ArticleStatistics in medicine2014
How to interpret a small increase in AUC with an additional risk prediction marker: decision analysis comes through.
Article in Statistics in medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 41 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
41 citing papers in PubMed, 2 syntheses or guidelines pooled it.
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- Clinical impact of MRI-based risk calculators for prostate cancer diagnosis: a systematic review and meta-analysis.Prostate cancer and prostatic diseases · 2026Pooled it
- Improving random forest predictions in small datasets from two-phase sampling designs.BMC medical informatics and decision making · 2021Trial
- Preoperative sodium abnormalities and adverse postoperative outcomes in older surgical patients: association and incremental predictive value in the BioCog cohort.European geriatric medicine · 2026Article
- From Fitness to Cognition: Machine-Learning Prediction of Cognitive Performance Using Physiological Parameters in Healthy Adults.Medicine and science in sports and exercise · 2026Article
- Association of nine composite inflammatory indices with cardiovascular diseases in US adults: national health and nutrition examination survey (NHANES, 2005-2018).Journal of health, population, and nutrition · 2026Article
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- Predictive value of urinary [TIMP-2]•[IGFBP7] for AKI among sepsis, stroke, and cardiac surgery cohorts: A prospective study.PloS one · 2025Observational
- Mortality following noncardiac surgery assessed by the Saint Louis University Score (SLUScore) for hypotension: a retrospective observational cohort study.British journal of anaesthesia · 2024Observational
- Polygenic risk score in comparison with C-reactive protein for predicting incident coronary heart disease.Atherosclerosis · 2023Article
- Integrating genome-wide polygenic risk scores and non-genetic risk to predict colorectal cancer diagnosis using UK Biobank data: population based cohort study.BMJ (Clinical research ed.) · 2022Article
- DNA methylation signatures of childhood trauma predict psychiatric disorders and other adverse outcomes 17 years after exposure.Molecular psychiatry · 2022Article
- Capturing additional genetic risk from family history for improved polygenic risk prediction.Communications biology · 2022Article
- Diagnosis of early stage knee osteoarthritis based on early clinical course: data from the CHECK cohort.Arthritis research & therapy · 2021Article
- A relationship between the incremental values of area under the ROC curve and of area under the precision-recall curve.Diagnostic and prognostic research · 2021Article
- Assessing the clinical utility of genetic profiling in fracture risk prediction: a decision curve analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021Article
- Association of Fatal and Nonfatal Cardiovascular Outcomes With 24-Hour Mean Arterial Pressure.Hypertension (Dallas, Tex. : 1979) · 2021Article
Corrections and comments
- Erratum issuedVickers, Andew [corrected to Vickers, Andrew]
- Erratum issued
Authors and funding
9 authors.
Funding
Abstract
An important question in the evaluation of an additional risk prediction marker is how to interpret a small increase in the area under the receiver operating characteristic curve (AUC). Many researchers believe that a change in AUC is a poor metric because it increases only slightly with the addition of a marker with a large odds ratio. Because it is not possible on purely statistical grounds to choose between the odds ratio and AUC, we invoke decision analysis, which incorporates costs and benefits. For example, a timely estimate of the risk of later non-elective operative delivery can help a woman in labor decide if she wants an early elective cesarean section to avoid greater complications from possible later non-elective operative delivery. A basic risk prediction model for later non-elective operative delivery involves only antepartum markers. Because adding intrapartum markers to this risk prediction model increases AUC by 0.02, we questioned whether this small improvement is worthwhile. A key decision-analytic quantity is the risk threshold, here the risk of later non-elective operative delivery at which a patient would be indifferent between an early elective cesarean section and usual care. For a range of risk thresholds, we found that an increase in the net benefit of risk prediction requires collecting intrapartum marker data on 68 to 124 women for every correct prediction of later non-elective operative delivery. Because data collection is non-invasive, this test tradeoff of 68 to 124 is clinically acceptable, indicating the value of adding intrapartum markers to the risk prediction model.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.