ArticleBMC medicine2023
There is no such thing as a validated prediction model.
Article in BMC medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 152 papers, 12 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
152 citing papers in PubMed, 12 syntheses or guidelines pooled it.
- Diagnostic performance of machine learning-based radiomics models for predicting epidermal growth factor receptor mutation status in lung adenocarcinoma in Chinese patients: A systematic review and meta-analysis.The Journal of international medical research · 2026Pooled it
- Diagnostic predictive models for cancer-related fatigue: current evidence and future directions.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Pooled it
- Predictive accuracy of surgeon gestalt for adverse postoperative outcomes: systematic review.The British journal of surgery · 2025Pooled it
- TRIPOD+AI statement: updated guidance for reporting clinical prediction models that use regression or machine learning methods: a Korean translation.Ewha medical journal · 2025Guideline
- Prognostic models for prediction of perioperative allogeneic red blood cell transfusion in adult cardiac surgery: A systematic review and meta-analysis.Transfusion · 2025Pooled it
- External validation of AI-based scoring systems in the ICU: a systematic review and meta-analysis.BMC medical informatics and decision making · 2025Pooled it
- Predictive models of Alzheimer's disease dementia risk in older adults with mild cognitive impairment: a systematic review and critical appraisal.BMC geriatrics · 2024Pooled it
- Prediction of Morbidity and Mortality After Esophagectomy: A Systematic Review.Annals of surgical oncology · 2024Pooled it
- Personalized decision-making for aneurysm treatment of aneurysmal subarachnoid hemorrhage: development and validation of a clinical prediction tool.BMC neurology · 2024Pooled it
- Research inefficiencies in external validation studies of the Framingham Wilson coronary heart disease risk rule: A systematic review.PloS one · 2024Pooled it
- APPRAISE-AI Tool for Quantitative Evaluation of AI Studies for Clinical Decision Support.JAMA network open · 2023Pooled it
- Applying Machine Learning Models to Predict Occupational Noise-Induced Hearing Loss: A Systematic Review and Meta-analysis.Noise & healthPooled it
- Development and preliminary validation of a PICC-related venous thrombosis risk prediction model for cancer patients: A systematic review and meta-analysis predominantly based on Chinese populations.Asia-Pacific journal of oncology nursing · 2026Review
- Type 2 diabetes subtypes for precision medicine: methodological challenges and alternative prediction-based approaches.Diabetologia · 2026Review
- Scoping review of methodology for aiding generalisability and transportability of clinical prediction models.Diagnostic and prognostic research · 2026Review
- Reproducibility in biomedical research.Nature medicine · 2026Review
- Pretreatment prediction of early severe treatment-related toxicity in older patients with lung adenocarcinoma: same-center temporal validation of a risk model.Journal of thoracic disease · 2026Article
- It Knows My Emotions Better Than I Do: Digital Phenotyping and the Contest Over Symptom Interpretation.Integrative psychological & behavioral science · 2026Article
- Consensus framework for the validation of generative AI: call for collaborators on the Validation Accords.Nature medicine · 2026Article
- The 40Journal of clinical research in pediatric endocrinology · 2026Article
92 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
4 authors.
Funding
Abstract
backgroundClinical prediction models should be validated before implementation in clinical practice. But is favorable performance at internal validation or one external validation sufficient to claim that a prediction model works well in the intended clinical context? MAIN BODY: We argue to the contrary because (1) patient populations vary, (2) measurement procedures vary, and (3) populations and measurements change over time. Hence, we have to expect heterogeneity in model performance between locations and settings, and across time. It follows that prediction models are never truly validated. This does not imply that validation is not important. Rather, the current focus on developing new models should shift to a focus on more extensive, well-conducted, and well-reported validation studies of promising models.
conclusionPrincipled validation strategies are needed to understand and quantify heterogeneity, monitor performance over time, and update prediction models when appropriate. Such strategies will help to ensure that prediction models stay up-to-date and safe to support clinical decision-making.
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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.