Altman D G, Royston P
ICRF Medical Statistics Group, Centre for Statistics in Medicine, Institute of Health Sciences, Old Road, Headington, Oxford OX3 7LF, UK.
Stat Med. 2000 Feb 29;19(4):453-73. doi: 10.1002/(sici)1097-0258(20000229)19:4<453::aid-sim350>3.0.co;2-5.
Prognostic models are used in medicine for investigating patient outcome in relation to patient and disease characteristics. Such models do not always work well in practice, so it is widely recommended that they need to be validated. The idea of validating a prognostic model is generally taken to mean establishing that it works satisfactorily for patients other than those from whose data it was derived. In this paper we examine what is meant by validation and review why it is necessary. We consider how to validate a model and suggest that it is desirable to consider two rather different aspects - statistical and clinical validity - and examine some general approaches to validation. We illustrate the issues using several case studies.
预后模型在医学中用于研究患者预后与患者及疾病特征之间的关系。这类模型在实际应用中并非总是能发挥良好作用，因此人们普遍建议对其进行验证。验证预后模型的概念通常被认为是要确定该模型对于除了其数据来源患者之外的其他患者也能令人满意地发挥作用。在本文中，我们探讨验证的含义，并审视其必要性。我们考虑如何验证一个模型，并提出需要考虑两个截然不同的方面——统计学有效性和临床有效性——并研究一些验证的一般方法。我们通过几个案例研究来说明这些问题。
