Decision curve analysis is a simple method for evaluating prediction models, diagnostic tests, and molecular markers.
The method was first published as:
Vickers AJ, Elkin EB. Decision curve analysis: a novel method for evaluating prediction models. Medical Decision Making. 2006 Nov-Dec;26(6):565-74.
A subsequent discussion paper gives some further details about the method:
Steyerberg EW, Vickers AJ. Decision curve analysis: a discussion. Medical Decision Making. 2008 Jan-Feb;28(1):146-9.
A paper describing various extensions to decision curve analysis, such as application to survival time data, is:
Vickers AJ, Cronin AM, Elkin EB, Gonen M. BMC Medical Informatics and Decision Making. 2008 Nov 26;8(1):53. Extensions to decision curve analysis, a novel method for evaluating diagnostic tests, prediction models and molecular markers.
For more on the theoretical background of decision curve analysis, see:
Vickers AJ. Decision analysis for the evaluation of diagnostic tests, prediction models and molecular markers. Am Stat. 2008;62(4):314-320.
Baker SG, Cook NR, Vickers A, Kramer BS. Using relative utility curves to evaluate risk prediction. J R Stat Soc Ser A Stat Soc. 2009 Oct 1;172(4):729-748.
Steyerberg EW, Vickers AJ, Cook NR, Gerds T, Gonen M, Obuchowski N, Pencina MJ, Kattan MW. Assessing the performance of prediction models: a framework for traditional and novel measures. Epidemiology. 2010 Jan;21(1):128-38.
Vickers AJ, Cronin AM. Traditional statistical methods for evaluating prediction models are uninformative as to clinical value: towards a decision analytic framework. Semin Oncol. 2010 Feb;37(1):31-8.
Two papers that extend decision curve analysis to issues of treatment response are:
Vickers AJ, Kattan MW, Daniel S. Method for evaluating prediction models that apply the results of randomized trials to individual patients. Trials. 2007;8:14
Vickers AJ, Kramer BS, Baker SG. Selecting patients for randomized trials: a systematic approach based on risk group. Trials. 2006;7:30.
Statistical Code for Running Decision Curve Analysis
Download Stata code
Download R code
Tutorials
Tutorials are available for both Stata and R. The tutorials include data sets, code and an Adobe Acrobat document taking the reader step by step through several different analyses.
