ArticleCirculation. Cardiovascular quality and outcomes2022
Generalizability of Cardiovascular Disease Clinical Prediction Models: 158 Independent External Validations of 104 Unique Models.
Article in Circulation. Cardiovascular quality and outcomes, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 2 of them syntheses that pooled it.
What it found
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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.
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Who cites it
34 citing papers in PubMed, 2 syntheses or guidelines pooled it, 44 citations in OpenAlex.
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- Research inefficiencies in external validation studies of the Framingham Wilson coronary heart disease risk rule: A systematic review.PloS one · 2024Pooled it
- ACCEPT 3.0: Recalibrating ACute COPD Exacerbation Prediction Tool (ACCEPT) for global use.Diagnostic and prognostic research · 2026Article
- The second beat matters: coupling intervals and sudden cardiac death risk in hypertrophic cardiomyopathy.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Article
- Predictive models of adverse outcomes of overweight or obesity: a nationwide cohort validation.BMC endocrine disorders · 2026Article
- Predicting unplanned 30-day hospital readmissions in patients with urogenital system disorders: a retrospective EMR-based ensemble learning study in Taiwan.BMC health services research · 2026Observational
- Effect of Using Personalized Estimates of Diabetes Risk During Primary Care Visits for People With Prediabetes.Learning health systems · 2026Article
- Risk prediction for individual patients and the pitfalls of selecting an optimal prediction model: do not judge a model by its c-statistic.European journal of epidemiology · 2026Article
- CARDIAC-FM: A Multimodal Foundation Model for Cardiovascular Risk Prediction Using ECG and Cardiac MRI.medRxiv : the preprint server for health sciences · 2026Article
- Computational approaches to multimodal data integration in rheumatoid arthritis: from data landscape to clinical translation.Briefings in bioinformatics · 2026Review
- Reframing precision nutrition in irritable bowel syndrome: a mechanism-informed conceptual framework for responder prediction and clinical translation.Frontiers in immunology · 2026Review
- Constructing a precise prediction model for screening growth hormone deficiency in children in a single laboratory setting: using the serum IGF-1-to-age ratio as a promising predictive marker.Translational pediatrics · 2025Article
- Secondary Prevention of AFAIS: Deploying Traditional Regression, Machine Learning, and Deep Learning Models to Validate and Update CHA2DS2-VASc for 90-Day Recurrence.Journal of clinical medicine · 2025Article
- Article
- Predicting prolonged work absence due to musculoskeletal disorders: development, validation, and clinical usefulness of prognostic prediction models.International archives of occupational and environmental health · 2025Article
- Multicenter Validation of a Machine Learning Model for Surgical Transfusion Risk at 45 US Hospitals.JAMA network open · 2025Article
- Instability of the AUROC of Clinical Prediction Models.Statistics in medicine · 2025Article
- Sharing reliable information worldwide: healthcare strategies based on artificial intelligence need external validation. Position paper.BMC medical informatics and decision making · 2025Article
- Validation, bias assessment, and optimization of the UNAFIED 2-year risk prediction model for undiagnosed atrial fibrillation using national electronic health data.Heart rhythm O2 · 2024Article
- Immune System-Related Plasma Pathogenic Extracellular Vesicle Subpopulations Predict Osteoarthritis Progression.International journal of molecular sciences · 2024Article
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Authors and funding
12 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhile clinical prediction models (CPMs) are used increasingly commonly to guide patient care, the performance and clinical utility of these CPMs in new patient cohorts is poorly understood.
methodsWe performed 158 external validations of 104 unique CPMs across 3 domains of cardiovascular disease (primary prevention, acute coronary syndrome, and heart failure). Validations were performed in publicly available clinical trial cohorts and model performance was assessed using measures of discrimination, calibration, and net benefit. To explore potential reasons for poor model performance, CPM-clinical trial cohort pairs were stratified based on relatedness, a domain-specific set of characteristics to qualitatively grade the similarity of derivation and validation patient populations. We also examined the model-based C-statistic to assess whether changes in discrimination were because of differences in case-mix between the derivation and validation samples. The impact of model updating on model performance was also assessed.
resultsDiscrimination decreased significantly between model derivation (0.76 [interquartile range 0.73-0.78]) and validation (0.64 [interquartile range 0.60-0.67],
conclusionsThere are significant decreases in model performance when applying cardiovascular disease CPMs to new patient populations, resulting in substantial risk of harm. Model updating can mitigate these risks. Care should be taken when using CPMs to guide clinical decision-making.
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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.