A framework for evaluating predictive models

Predictive models provide estimates on an individual's probability of having a disease or developing a disease/disease outcome. Clinicians often use them to support clinical decision-making. Many prediction models are published annually; online versions of models (such as MDCalc and QxMD) facilitate their use at the point of care. However, before using a model, the clinician should first establish that the model has undergone external validation demonstrating satisfactory predictive performance. Ideally, the model should also demonstrate improved outcomes from an impact analysis. This article summarizes the basic steps of predictive model evaluation, and is followed by an application example.