The power‐integrated discriminant improvement: An accurate measure of the incremental predictive value of additional biomarkers

Hayashi, Kenichi; Eguchi, Shinto

doi:10.1002/sim.8135

Cited by 23 publications

(20 citation statements)

References 33 publications

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“…The additional discriminative capacity of the aorto-iliac CaScore compared to a basic model (gender and age), the Charlson Comorbidity Index, and the Framingham score was assessed using C-statistics (Harrell's concordance index), a change in C-statistics, and the integrated discrimination improvement (IDI). The IDI is a statistical method to describe the predictive performance of biomarkers in extensive regression models, by comparing an initial model with a model including this new biomarker [31]. A p-value of <0.05 was considered statistically significant.…”

Section: Discussionmentioning

confidence: 99%

Aorto-Iliac Artery Calcification Prior to Kidney Transplantation

Benjamens

Rijkse

Velde-Keyzer

et al. 2020

JCM

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As vascular calcification is common in kidney transplant candidates, aorto-iliac vessel imaging is performed for surgical planning. The aim of the present study was to investigate whether a novel non-contrast enhanced computed tomography-based quantification technique for aorto-iliac calcification can be used for cardiovascular risk stratification prior to kidney transplantation. In this dual-center cohort study, we measured the aorto-iliac calcium score (CaScore) of 547 patients within three years prior to transplantation (2005–2018). During a median (interquartile range) follow-up of 3.1 (1.4, 5.2) years after transplantation, 80 (14.7%) patients died, of which 32 (40.0%) died due to cardiovascular causes, and 84 (15.5%) patients had a cardiovascular event. Kaplan-Meier survival curves showed significant differences between the CaScore tertiles for cumulative overall-survival (Log-rank test p < 0.0001), cardiovascular survival (p < 0.0001), and cardiovascular event-free survival (p < 0.001). In multivariable Cox regression, the aorto-iliac CaScore was associated with all-cause mortality (hazard ratio 1.53, 95%CI 1.14–2.06, p = 0.005), cardiovascular mortality (2.04, 1.20–3.45, p = 0.008), and cardiovascular events (1.35, 1.01–1.80, p = 0.042). These independent associations of the aorto-iliac CaScore with the outcome measures can improve the identification of patients at risk for (cardiovascular) death and those who could potentially benefit from stringent cardiovascular monitoring to improve their prognosis after transplantation.

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Section: Discussionmentioning

confidence: 99%

Aorto-Iliac Artery Calcification Prior to Kidney Transplantation

Benjamens

Rijkse

Velde-Keyzer

et al. 2020

JCM

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“…The NRI and IDI are evaluation indicators of model effectiveness. [31][32][33] Compared with the AJCC staging system, the NRI and IDI of the nomogram were higher at 1, 3 and 5 years after diagnosis. DCA is generally considered to be useful for verifying the bene ts and clinical effectiveness of the model.…”

Section: Discussionmentioning

confidence: 90%

“…Table 1 shows the basic characteristics of the patients with PDAC-HP. In this study, we collected 33 The hazard ratio (HR) and 95% con dence interval (CI) of each factor related to the OS of patients with PDAC-HP are shown in Table 2. Using Cox regression analysis, we screened out independent risk factors that affect the OS of patients with PDAC-HP, such as age at diagnosis (HR = 1.01, 95% CI = 1.01-1.02, P < 0.001), sex (female vs male: HR = 1.07, 95% CI = 1.05-1.10, P < 0.001), marital status at diagnosis (unmarried vs married: HR = 1.95, 95% CI = 1.66-2.28, P < 0.001), race (white vs black: HR = 1.12, 95% CI = 1.09-1.15, P < 0.001), AJCC staging (II vs I: HR = 1.27, 95% CI = 1.19-1.35, P < 0.001; III vs I: HR = 1.30, 95% CI = 1.19-1.41, P < 0.001; IV vs I: HR = 1.80, 95% CI = 1.60-2.02, P < 0.001), surgery (yes vs no: HR = 0.41, 95% CI = 0.40-0.41, P < 0.001), radiotherapy (yes vs no: HR = 0.91, 95% CI = 0.88-0.95, P < 0.001), and chemotherapy (yes vs no: HR = 0.46, 95% CI = 0.44-0.47, P < 0.001).…”

Section: Patient Basic Characteristicsmentioning

confidence: 99%

Development and validation of a Nomogram for predicting the Overall Survival of Patients With Pancreatic Ductal Adenocarcinoma of the Head of the Pancreas

Liu

Cao

et al. 2021

Preprint

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Background: The purpose of this study is to develop and validate a nomogram to predict the overall survival (OS) of patients with Pancreatic Ductal Adenocarcinoma of the Head of the Pancreas (PDAC-HP).Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database, we collected patients with PDAC-HP in the United States between 2004 and 2015. Patients were randomly divided into training set and validating set at a ratio of 7:3. The training set is used to develop a nomogram for predicting OS. These indicators such as the C index, the area under curve (AUC) of the receiver operating characteristic (ROC), calibration plots and the net reclassification improvement (NRI) and the integrated discrimination improvement (IDI) were used to evaluate the prediction accuracy of the nomogram.Results: A total of 33,893 patients with PDAC-HP over 20 years old were diagnosed between 2004 and 2015 were collected from the SEER database. Using multivariable Cox regression analysis, we identified eight risk factors that were associated with OS, such as age at diagnosis, sex, marital status at diagnosis, race, AJCC staging, surgery, radiotherapy and chemotherapy. A nomogram was constructed based on these variables. Compared with the AJCC staging system, the nomogram has a better C index and AUC in the training set and validatiing set. The calibration plots indicated that the nomogram was able to accurately predict the OS of patients with PDAC-HP at 1, 3, and 5 years.Conclusions: We developed and validated a nomogram, and predicted the OS of patients with PDAC-HP at 1, 3, and 5 years. Compared with the AJCC staging system, the nomogram we constructed has better performance. It shows that our nomogram could be served as an effective tool for prognostic evaluation of patients with PDAC-HP.

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“…The discriminative ability, accuracy and incremental predictive value of the prognostic nomogram to the traditional TNM staging system for individualized survival was evaluated by the Harrell's concordance index (C-index), decision curve analysis (DCA), 40 net reclassification improvement (NRI), 41 and integrated discrimination improvement (IDI). 42 Throughout the study, statistical significance was set at P < 0.05 (two-tailed).…”

Section: Statistical Analysesmentioning

confidence: 99%

A Survival Prediction Nomogram for Esophageal Squamous Cell Carcinoma Treated with Neoadjuvant Chemoradiotherapy Followed by Surgery

Ding¹,

Liu²,

Huang³

et al. 2021

CMAR

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Background: Neoadjuvant chemoradiotherapy (NCRT) followed by surgery is a component of the standard treatment for resectable locally advanced esophageal squamous cell carcinoma (ESCC), and the parameters for survival prediction are not clear yet. Our study aimed to construct a survival prediction nomogram for ESCC with NCRT followed by surgery. Methods: We analyzed hematological parameters and related-derivative indexes from 122 ESCC patients treated with NCRT followed by surgery. Univariate and multivariate Cox survival analyses were performed to identify independent prognostic factors to establish a nomogram and predict overall survival (OS). The predictive value of the nomogram for OS was evaluated by the concordance index (C-index), decision curve analysis (DCA), the clinical impact curve (CIC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Results: The pretreatment nutritional candidate, prognostic nutrition index, inflammationrelated absolute monocyte count and TNM staging were entered into the nomogram for ESCC with NCRT followed by surgery. The C-index of the nomogram for OS was 0.790 (95% CI = 0.688-0.893), which was higher than that of TNM staging (0.681; 95% CI = 0.565-0.798, P = 0.026). The DCA, CIC, NRI, and IDI of the nomogram showed moderate improvement in predicting survival. Based on the cut point calculated according to the constructed nomogram, the high-risk group had poorer OS than that of the low-risk group (P < 0.05). Conclusion:A novel nomogram based on nutrition-and inflammation-related indicators might help predict the survival of ESCC treated with NCRT followed by surgery.

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The power‐integrated discriminant improvement: An accurate measure of the incremental predictive value of additional biomarkers

Cited by 23 publications

References 33 publications

Aorto-Iliac Artery Calcification Prior to Kidney Transplantation

Aorto-Iliac Artery Calcification Prior to Kidney Transplantation

Development and validation of a Nomogram for predicting the Overall Survival of Patients With Pancreatic Ductal Adenocarcinoma of the Head of the Pancreas

A Survival Prediction Nomogram for Esophageal Squamous Cell Carcinoma Treated with Neoadjuvant Chemoradiotherapy Followed by Surgery

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