ArticleThe spine journal : official journal of the North American Spine Society2021
Decision curve analysis to evaluate the clinical benefit of prediction models.
Article in The spine journal : official journal of the North American Spine Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 250 papers, 4 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
250 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Performance of AI-Based Screening Tools for Obstructive Sleep Apnea Across Apnea-Hypopnea Index Thresholds: Systematic Review and Meta-Analysis.Journal of medical Internet research · 2026Pooled it
- Machine Learning to Predict Extranodal Extension in Head and Neck Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis.The Laryngoscope · 2026Pooled it
- Risk prediction models for oral frailty in older adults: a scoping review.Frontiers in medicine · 2026Pooled it
- Risk prediction models for enteral feeding intolerance in critically ill patients: a systematic review.Frontiers in public health · 2026Pooled it
- [European journal of nuclear medicine and molecular imaging · 2026Trial
- Early Radiographic Changes Predict Radiographic Stability in Distal Radius Fractures: Development and Validation of an Explainable Predictive Model.Journal of hand surgery global online · 2027Article
- Clinician-accessible automated machine learning in oral healthcare: A systematic review.The Japanese dental science review · 2026Review
- Dose-conditioned machine-learning prediction of a composite target sedation state in patients undergoing propofol-sedated gastrointestinal endoscopy.Annals of medicine · 2026Observational
- Profiling Gut Microbiome and Metabolites Aids Diagnosis and Prediction of Progression in Mild Cognitive Impairment.MedComm · 2026Article
- Machine learning prediction model for distant metastasis at diagnosis in pediatric neuroblastoma: development, interpretation, and temporal validation.Translational pediatrics · 2026Article
- Artificial Intelligence in Cerebral Small Vessel Disease Imaging: A Study-Level Cross-Sectional Analysis of Validation Status and Clinical Applicability.Journal of imaging informatics in medicine · 2026Article
- Comment on 'Association between lactate-to-albumin ratio and postoperative delirium in elderly patients undergoing cardiac surgery' by Zhu et al.Journal of anesthesia · 2026Article
- Hematological Versus Clinical Predictors of Tumor Grade in Endometrial Cancer: A Comparative Machine Learning Study with SHAP-Based Explainability.Diagnostics (Basel, Switzerland) · 2026Article
- Development of a heart failure with preserved ejection fraction risk prediction score in primary care settings with a high HIV prevalence.Open heart · 2026Observational
- Intrinsic capacity impairment and incident dementia across three population-based cohorts: a harmonized individual participant data analysis.The journal of nutrition, health & aging · 2026Article
- Review
- Temporal Variability in Routine Mobility Documentation as an Early Signal of Functional Decline in Skilled Nursing Facilities: A Feasibility and Methods Study.Archives of rehabilitation research and clinical translation · 2026Article
- Evaluation of explainable machine learning models for predicting mid-term stone recurrence after percutaneous nephrolithotomy: a retrospective observational cohort study.International urology and nephrology · 2026Observational
- Development and Validation of an Interpretable Machine Learning Model for Predicting ICU-Acquired Weakness in Postoperative Patients.Nursing in critical care · 2026Article
- AI parameters for enhancing spine surgery outcomes: a narrative review.Journal of spine surgery (Hong Kong) · 2026Review
190 more citing papers are in PubMed but not listed here.
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Authors and funding
2 authors.
Funding
Abstract
There is increased interest in the use of prediction models to guide clinical decision-making in orthopedics. Prediction models are typically evaluated in terms of their accuracy: discrimination (area-under-the-curve [AUC] or concordance index) and calibration (a plot of predicted vs. observed risk). But it can be hard to know how high an AUC has to be in order to be "high enough" to warrant use of a prediction model, or how much miscalibration would be disqualifying. Decision curve analysis was developed as a method to determine whether use of a prediction model in the clinic to inform decision-making would do more good than harm. Here we give a brief introduction to decision curve analysis, explaining the critical concepts of net benefit and threshold probability. We briefly review some prediction models reported in the orthopedic literature, demonstrating how use of decision curves has allowed conclusions as to the clinical value of a prediction model. Conversely, papers without decision curves were unable to address questions of clinical value. We recommend increased use of decision curve analysis to evaluate prediction models in the orthopedics literature.
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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.