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The method of decision curve analysis is then as follows: 1. Select a p t 2. Define a patient as positive if p ^ ≥ p t 3. Calculate the number of true and false positives 4. Calculate net benefit 5. Repeat for a range of p t 6. Repeat steps 1 – 5 for all models and for the strategy of treat all patients (i.e. p ^ = 1) A typical decision curve is given in Figure 1.
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We hope that our remarks will facilitate interpretation of decision curve analysis and motivate a more widespread adoption of the method.
The results of decision curve analysis are compared by means of decision curves, with separate decision curves for the classification models and the independent clinical variables in isolation.
We recall the foundations of decision curve analysis and discuss some new aspects.
We have recalled the foundations of decision curve analysis and discussed some new aspects.
Calculation of decision curves directly from predicted probabilities led to a smoothing of the decision curve.
We have presented no method for correcting decision curve analysis for overfit.
New methods based on decision curve analysis (net benefit) [ 50] and relative utility [ 51] have recently been introduced.
The simulation results comparing the correction methods for the decision curve net benefits are shown in Table 2.
The method for applying decision curves to censored data had little bias and coverage was excellent; for competing risk, decision curves were appropriately affected by the incidence of the competing risk and the association between the competing risk and the predictor of interest.
We therefore recommend repeated 10-fold cross-validation as a method to correct decision curves created using the same data as that used to generate the model.
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