Resampling and cross-validation techniques: a tool to reduce bias caused by model building?

Stat Med. 1997 Dec 30;16(24):2813-27. doi: 10.1002/(sici)1097-0258(19971230)16:24<2813::aid-sim701>;2-z.


The process of model building involved in the analysis of many medical studies may lead to a considerable amount of over-optimism with respect to the predictive ability of the 'final' regression model. In this paper we illustrate this phenomenon in a simple cutpoint model and explore to what extent bias can be reduced by using cross-validation and bootstrap resampling. These computer intensive methods are compared to an ad hoc approach and to a heuristic method. Besides illustrating all proposals with the data from a breast cancer study we perform a simulation study in order to assess the quality of the methods.

MeSH terms

  • Bias
  • Breast Neoplasms / diagnosis
  • Computer Simulation
  • DNA, Neoplasm / analysis
  • Disease-Free Survival
  • Female
  • Flow Cytometry
  • Humans
  • Models, Statistical*
  • Prognosis
  • Regression Analysis
  • Reproducibility of Results*
  • Research Design*


  • DNA, Neoplasm