Comparison of approaches for incorporating new information into existing risk prediction models

Sonja Grill, Donna P. Ankerst, Mitchell H. Gail, Nilanjan Chatterjee, Ruth M. Pfeiffer

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


We compare the calibration and variability of risk prediction models that were estimated using various approaches for combining information on new predictors, termed ‘markers’, with parameter information available for other variables from an earlier model, which was estimated from a large data source. We assess the performance of risk prediction models updated based on likelihood ratio (LR) approaches that incorporate dependence between new and old risk factors as well as approaches that assume independence (‘naive Bayes’ methods). We study the impact of estimating the LR by (i) fitting a single model to cases and non-cases when the distribution of the new markers is in the exponential family or (ii) fitting separate models to cases and non-cases. We also evaluate a new constrained maximum likelihood method. We study updating the risk prediction model when the new data arise from a cohort and extend available methods to accommodate updating when the new data source is a case-control study. To create realistic correlations between predictors, we also based simulations on real data on response to antiviral therapy for hepatitis C. From these studies, we recommend the LR method fit using a single model or constrained maximum likelihood.

Original languageEnglish (US)
Pages (from-to)1134-1156
Number of pages23
JournalStatistics in Medicine
Issue number7
StatePublished - Mar 30 2017


  • calibration
  • discrimination
  • independence Bayes
  • model updating
  • risk prediction

ASJC Scopus subject areas

  • Epidemiology
  • Statistics and Probability


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