Abstract
Doctors' survival predictions for terminally ill patients have been shown to be inaccurate and there has been an argument for less guesswork and more use of carefully constructed statistical indices. As statisticians, the authors are less confident in the predictive value of statistical models and indices for individual survival times. This paper discusses and illustrates a variety of measures which can be used to summarise predictive information available from a statistical model. The authors argue that models and statistical indices can be useful at the group or population level, but that human survival is so uncertain that even the best statistical analysis cannot provide single-number predictions of real use for individual patients.
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Selected References
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- Altman D. G., Royston P. What do we mean by validating a prognostic model? Stat Med. 2000 Feb 29;19(4):453–473. doi: 10.1002/(sici)1097-0258(20000229)19:4<453::aid-sim350>3.0.co;2-5. [DOI] [PubMed] [Google Scholar]
- Christakis N. A., Lamont E. B. Extent and determinants of error in doctors' prognoses in terminally ill patients: prospective cohort study. BMJ. 2000 Feb 19;320(7233):469–472. doi: 10.1136/bmj.320.7233.469. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Henderson R., Jones M., Stare J. Accuracy of point predictions in survival analysis. Stat Med. 2001 Oct 30;20(20):3083–3096. doi: 10.1002/sim.913. [DOI] [PubMed] [Google Scholar]
- Henderson Robin, Keiding Niels. Forudsigelse af individuelle levetider ved hjaelp af statistiske modeller. Ugeskr Laeger. 2005 Mar 7;167(10):1174–1177. [PubMed] [Google Scholar]
- Hollnagel H. Explaining risk factors to patients during a general practice consultation. Conveying group-based epidemiological knowledge to individual patients. Scand J Prim Health Care. 1999 Mar;17(1):3–5. doi: 10.1080/028134399750002809. [DOI] [PubMed] [Google Scholar]
- Muers M. F., Shevlin P., Brown J. Prognosis in lung cancer: physicians' opinions compared with outcome and a predictive model. Thorax. 1996 Sep;51(9):894–902. doi: 10.1136/thx.51.9.894. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Parkes C. M. Commentary: prognoses should be based on proved indices not intuition. BMJ. 2000 Feb 19;320(7233):473–473. [PubMed] [Google Scholar]