Is My Clinical Prediction Model Clinically Useful? A Primer on Decision Curve Analysis

Acta Neurochir Suppl. 2022:134:115-118. doi: 10.1007/978-3-030-85292-4_15.


Decision curve analysis is an increasingly popular method to assess the impact of a prediction model on medical decision making. The analysis provides a graphical summary. A basic understanding of a decision curve is needed to interpret these graphics. This short introduction addresses the common features of a decision curve. Furthermore, using a glioblastoma patient set provided by the Machine Intelligence in Clinical Neuroscience Lab from the Department of Neurosurgery and Clinical Neuroscience Center, University Hospital Zurich a decision curve is plotted for two prediction models. The corresponding R code is provided.

Keywords: Decision curve analysis; Net benefit; Prediction model; Tutorial paper.

MeSH terms

  • Clinical Decision-Making
  • Humans
  • Models, Statistical*
  • Neurosurgery*
  • Prognosis
  • ROC Curve