Evaluating Health Risk Models

Details Evaluating Health Risk Models Evaluating Health Risk Models

2009-06-12

arxiv.org/abs/0906.2691v1

Statistics

Methodology

17 pages, 3 tables, and 5 figures

Scientific paper

Interest in targeted disease prevention has stimulated development of models that assign risks to individuals, using their personal covariates. We need to evaluate these models, and to quantify the gains achieved by expanding a model with additional covariates. We describe several performance measures for risk models, and show how they are related. Application of the measures to risk models for hypothetical populations and for postmenopausal US women illustrate several points. First, model performance is constrained by the distribution of true risks in the population. This complicates the comparison of two models if they are applied to populations with different covariate distributions. Second, the Brier Score and the Integrated Discrimination Improvement (IDI) are more useful than the concordance statistic for quantifying precision gains obtained from model expansion. Finally, these precision gains are apt to be small, although they may be large for some individuals. We propose a new way to identify these individuals, and show how to quantify how much they gain by measuring the additional covariates. Those with largest gains could be targeted for cost-efficient covariate assessment.

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