Evidence map›Paper›PMID 31093561›Full record

ArticleDiagnostic and prognostic research2018

Evaluating the impact of prediction models: lessons learned, challenges, and recommendations.

Teus H Kappen, Wilton A van Klei, Leo van Wolfswinkel, Cor J Kalkman, Yvonne Vergouwe, Karel G M Moons

Open access · goldAbstract read
In one paragraph

Article in Diagnostic and prognostic research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 100 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
100citing papers in PubMed, 12 pooled it
19.9field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

100 citing papers in PubMed, 12 syntheses or guidelines pooled it, 201 citations in OpenAlex.

  1. Risk prediction for lung cancer screening: a systematic review and meta-regression.European respiratory review : an official journal of the European Respiratory Society · 2026
    Pooled it
  2. Prognostic models for all-cause and cardiovascular mortality in type 2 diabetes: Systematic review.Diabetic medicine : a journal of the British Diabetic Association · 2026
    Pooled it
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  5. Facilitators and Barriers of the Use of Prognostic Models for Clinical Decision Making in Acute Neurologic Care: A Systematic Review.Medical decision making : an international journal of the Society for Medical Decision Making · 2025
    Pooled it
  6. Systematic Review of Clinical Prediction Models for the Risk of Emergency Caesarean Births.BJOG : an international journal of obstetrics and gynaecology · 2025
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  14. The effect of proactiveBJA open · 2024
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40 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Teus H KappenDivision of Anesthesiology, Intensive Care and Emergency Medicine, University Medical Center Utrecht, Utrecht University, P.O. Box 85500, Mail stop F.06.149, 3508 GA Utrecht, The Netherlands.ORCID 0000-0003-1895-0998
Wilton A van KleiDivision of Anesthesiology, Intensive Care and Emergency Medicine, University Medical Center Utrecht, Utrecht University, P.O. Box 85500, Mail stop F.06.149, 3508 GA Utrecht, The Netherlands.
Leo van WolfswinkelDivision of Anesthesiology, Intensive Care and Emergency Medicine, University Medical Center Utrecht, Utrecht University, P.O. Box 85500, Mail stop F.06.149, 3508 GA Utrecht, The Netherlands.
Cor J KalkmanDivision of Anesthesiology, Intensive Care and Emergency Medicine, University Medical Center Utrecht, Utrecht University, P.O. Box 85500, Mail stop F.06.149, 3508 GA Utrecht, The Netherlands.
Yvonne Vergouwe2Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands.
Karel G M MoonsDivision of Anesthesiology, Intensive Care and Emergency Medicine, University Medical Center Utrecht, Utrecht University, P.O. Box 85500, Mail stop F.06.149, 3508 GA Utrecht, The Netherlands.
Utrecht University · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

An important aim of clinical prediction models is to positively impact clinical decision making and subsequent patient outcomes. The impact on clinical decision making and patient outcome can be quantified in prospective comparative-ideally cluster-randomized-studies, known as 'impact studies'. However, such impact studies often require a lot of time and resources, especially when they are (cluster-)randomized studies. Before envisioning such large-scale randomized impact study, it is important to ensure a reasonable chance that the use of the prediction model by the targeted healthcare professionals and patients will indeed have a positive effect on both decision making and subsequent outcomes. We recently performed two differently designed, prospective impact studies on a clinical prediction model to be used in surgical patients. Both studies taught us new valuable lessons on several aspects of prediction model impact studies, and which considerations may guide researchers in their decision to conduct a prospective comparative impact study. We provide considerations on how to prepare a prediction model for implementation in practice, how to present the model predictions, and how to choose the proper design for a prediction model impact study.

Indexed as

DiagnosisImpact studiesImplementationPrediction modelsPrognosisStudy design

Identifiers

PMID31093561
PMCPMC6460651
OpenAlexW2808649887

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.