ArticleStatistics in biosciences2015
The Net Reclassification Index (NRI): a Misleading Measure of Prediction Improvement Even with Independent Test Data Sets.
Article in Statistics in biosciences, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 105 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
105 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Characteristics of Cardiovascular Disease Prediction Models Considering Mental Disorders: A Systematic Review.Journal of the American Heart Association · 2026Pooled it
- Prognostic value of left atrial function in cardiac amyloidosis: a systematic review and meta‑analysis.The international journal of cardiovascular imaging · 2026Pooled it
- Mortality Risk Prediction Models for People With Kidney Failure: A Systematic Review.JAMA network open · 2025Pooled it
- Methodological guidance for the evaluation and updating of clinical prediction models: a systematic review.BMC medical research methodology · 2022Pooled it
- A methodology review on the incremental prognostic value of computed tomography biomarkers in addition to Framingham risk score in predicting cardiovascular disease: the use of association, discrimination and reclassification.BMC cardiovascular disorders · 2018Pooled it
- Establishment of a prognostic model for patients with sepsis based on SOFA: a retrospective cohort study.The Journal of international medical research · 2021Trial
- Improved Detection of Abnormal Glucose Tolerance in Africans: The Value of Combining Hemoglobin ADiabetes care · 2020Trial
- Prognosis and Reclassification by YKL-40 in Stable Coronary Artery Disease.Journal of the American Heart Association · 2020Trial
- A Study Investigating Markers in PLeural Effusion (SIMPLE): a prospective and double-blind diagnostic study.BMJ open · 2019Trial
- Why decision curves cross treat-all and treat-none: A PPV and calibration perspective.Global epidemiology · 2026Article
- A multimodal model for clinically defined MCI integrating plasma biomarkers and brain microstructural features: a dual-cohort external validation study.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
- External conditioning of data collection enhances the information content from wearable sensors.NPJ cardiovascular health · 2026Article
- Predicting Recurrence and Outcomes After Stressor-Associated Atrial Fibrillation Using ECG-Based Deep Learning.Journal of the American Heart Association · 2026Article
- Risk Prediction in Cardio-Oncology: Conceptual and Methodological Considerations: JACC: CardioOncology State-of-the-Art Review.JACC. CardioOncology · 2026Review
- PACU Delirium in Older Surgical Patients: Incidence, Nursing-Sensitive Correlates, and Outcomes in a Multicenter Chinese Cohort Study.Clinical interventions in aging · 2026Article
- Incremental value of placental miR-7641 and ferroptosis-related phenotypes in risk stratification of severe preeclampsia.Frontiers in physiology · 2026Article
- Machine learning prediction of overall survival in patients with cT1b renal cell carcinoma after surgical resection using the SEER database.Scientific reports · 2025Article
- Article
- Weighted Brier Score - an Overall Summary Measure for Risk Prediction Models with Clinical Utility Consideration.Statistics in biosciences · 2025Article
- Enhancing Cardiovascular Risk Prediction with a Simplified Carotid IMT Protocol: Evidence from the IMPROVE Study.Biomedicines · 2025Article
45 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
The Net Reclassification Index (NRI) is a very popular measure for evaluating the improvement in prediction performance gained by adding a marker to a set of baseline predictors. However, the statistical properties of this novel measure have not been explored in depth. We demonstrate the alarming result that the NRI statistic calculated on a large test dataset using risk models derived from a training set is likely to be positive even when the new marker has no predictive information. A related theoretical example is provided in which an incorrect risk function that includes an uninformative marker is proven to erroneously yield a positive NRI. Some insight into this phenomenon is provided. Since large values for the NRI statistic may simply be due to use of poorly fitting risk models, we suggest caution in using the NRI as the basis for marker evaluation. Other measures of prediction performance improvement, such as measures derived from the ROC curve, the net benefit function and the Brier score, cannot be large due to poorly fitting risk functions.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.