Now up at #EuroCIM2020: Saskia le Cessie and @GelovenNan with ‘Prediction meets causal inference: the role of treatment in clinical prediction models’
Mapping the ICH E9(R1) addendum on estimands to clinical prediction models with treatment initiation following the moment of prediction
1. & #39;Ignore treatment& #39; strategy, similar to treatment policy estimand, hopefully self-explanatory
2. & #39;Composite& #39; strategy, where treatment initiation counts as an event (so you model min of time to event and time to treatment). Estimation straightforward. Assumptions about future treatment initiation might be wobbly.
3. & #39;While untreated& #39; predicts the risk of an event before time t. Estimation using competing risk approaches
4. & #39;Hypothetical& #39; strategy predicts the risk in a hypothetical world where treatment does not exist. Nice in that it can inform future treatment decisions. Estimation is more difficult and requires various CI assumptions.
. @GelovenNan is now showing an example in practice. Patients with end-stage renal disease starting on dialysis; some receive a transplant; main outcome of interest is death
We& #39;re now having a role play where @GelovenNan plays a doctor explaining predictions to her patient, Saskia le Sessie. This is AMAZING!
Conclusion: the meaning of predictions provided to patients should be well-defined and crystal clear
So the paper is accepted by European Journal of Epi
and if you just can& #39;t wait, there is a pre-print up at https://arxiv.org/abs/2004.06998
(CoI:">https://arxiv.org/abs/2004.... I live-tweeted this because I& #39;m an author)
and if you just can& #39;t wait, there is a pre-print up at https://arxiv.org/abs/2004.06998
(CoI:">https://arxiv.org/abs/2004.... I live-tweeted this because I& #39;m an author)
Interesting questions:
@RuthHKeogh – What about model validation/assessment when we have defined predictimands?
Ian White – What about model selection? Might you use different covariates for different predictimands?
[I missed the other one]
@RuthHKeogh – What about model validation/assessment when we have defined predictimands?
Ian White – What about model selection? Might you use different covariates for different predictimands?
[I missed the other one]
Here& #39;s the hypothetical conversation between doctor and patient that explains the different predictimands. IMO this demonstrates nicely how each predictimand is of interest.