ArticleInternational journal of epidemiology2022
Lessons learnt when accounting for competing events in the external validation of time-to-event prognostic models.
Article in International journal of epidemiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed, 45 citations in OpenAlex.
- Planning of kidney replacement therapy in advanced CKD using the KFRE formula in a Spanish multicenter cohort.Clinical kidney journal · 2026Article
- The kidney failure risk equation in people with CKD and multimorbidity: the effect of competing mortality risks.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026Observational
- Derivation and Validation of Risk Prediction Models for Cardiovascular and Kidney Outcomes of Non-ST-Segment-Elevation Acute Coronary Syndrome in Patients With Chronic Kidney Disease.Journal of the American Heart Association · 2026Article
- Machine Learning Models for Individualized Osteoradionecrosis Risk Prediction in Head and Neck Cancer.Journal of medical systems · 2026Article
- Changing from the CKD-EPI to the EKFC creatinine equation to estimate glomerular filtration rate in adults in a Northern European health system.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026Article
- Forecasting Waitlist Trajectories for Patients With Metabolic Dysfunction-Associated Steatohepatitis Cirrhosis: A Neural Network Competing Risk Analysis.Journal of medical Internet research · 2026Article
- Risk-based referral model to nephrologist specialist care in Stockholm.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025Observational
- External validation, recalibration, and clinical utility of the kidney failure risk equation in patients with advanced CKD: a nationwide retrospective cohort analysis in Peru.BMC nephrology · 2025Article
- Kidney Failure Risk Equation performance according to the etiology of chronic kidney disease in the CKD-CAREMEAU cohort.Clinical kidney journal · 2025Article
- Early detection of ICU-acquired infections using high-frequency electronic health record data.BMC medical informatics and decision making · 2025Article
- Predicting Hospitalization and Related Outcomes in Advanced Chronic Kidney Disease: A Systematic Review, External Validation, and Development Study.Kidney medicine · 2025Article
- Frailty in Adults with CKD and Validation of the Kidney Failure Risk Equation in Frailty Subgroups.Clinical journal of the American Society of Nephrology : CJASN · 2025Article
- Machine learning based identification of suicidal ideation using non-suicidal predictors in a university mental health clinic.Scientific reports · 2025Article
- Competing and Noncompeting Risk Models for Predicting Kidney Allograft Failure.Journal of the American Society of Nephrology : JASN · 2025Article
- External validation of the Leiden Thrombosis Recurrence Risk Prediction models (L-TRRiP) for the prediction of recurrence after a first venous thrombosis in the Heart and Vascular Health study.Research and practice in thrombosis and haemostasis · 2024Article
- A tool to predict the risk of lower extremity amputation in patients starting dialysis.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2024Article
- Weighted metrics are required when evaluating the performance of prediction models in nested case-control studies.BMC medical research methodology · 2024Article
- Development of a risk prediction model for subsequent infection after colonization with carbapenem-resistant Enterobacterales: a retrospective cohort study.Antimicrobial resistance and infection control · 2024Article
- Predicting the risks of kidney failure and death in adults with moderate to severe chronic kidney disease: multinational, longitudinal, population based, cohort study.BMJ (Clinical research ed.) · 2024Article
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Corrections and comments
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Authors and funding
8 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExternal validation of prognostic models is necessary to assess the accuracy and generalizability of the model to new patients. If models are validated in a setting in which competing events occur, these competing risks should be accounted for when comparing predicted risks to observed outcomes.
methodsWe discuss existing measures of calibration and discrimination that incorporate competing events for time-to-event models. These methods are illustrated using a clinical-data example concerning the prediction of kidney failure in a population with advanced chronic kidney disease (CKD), using the guideline-recommended Kidney Failure Risk Equation (KFRE). The KFRE was developed using Cox regression in a diverse population of CKD patients and has been proposed for use in patients with advanced CKD in whom death is a frequent competing event.
resultsWhen validating the 5-year KFRE with methods that account for competing events, it becomes apparent that the 5-year KFRE considerably overestimates the real-world risk of kidney failure. The absolute overestimation was 10%age points on average and 29%age points in older high-risk patients.
conclusionsIt is crucial that competing events are accounted for during external validation to provide a more reliable assessment the performance of a model in clinical settings in which competing risks occur.
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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.