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The relationship between the C-statistic and the accuracy of program-specific evaluations.
- Source :
-
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2019 Feb; Vol. 19 (2), pp. 407-413. Date of Electronic Publication: 2018 Oct 29. - Publication Year :
- 2019
-
Abstract
- The C-statistic of the risk-adjustment model is often used to judge the accuracy of program evaluations. However, the C-statistic depends on the variability in risk for individual transplants and may be inappropriate for determining the accuracy of program evaluations. A simulation study investigated the association of the C-statistic with several metrics of program evaluation accuracy, including categorizing programs into the 5-tier system and identifying programs for regulatory review. The simulation study used data from deceased donor kidney-alone transplants for adult recipients in the program-specific reports released January 2018. A range of C-statistics was generated by changing the variability in risk for individual transplants. The C-statistic had no association with any metric of program evaluation accuracy. Instead, the number of expected events at a program was the most important factor. For example, Spearman's rho, which is the correlation of ranks, was -0.27 and -0.72 between the true program-specific hazard ratios and assigned tiers for programs with, respectively, <3 and >10 expected events. Presence of unadjusted risk factors did not modify the associations, although the accuracy of program evaluations was systematically lower. Therefore, the C-statistic provides no information on the accuracy of program evaluations.<br /> (Published 2018. This article is a U.S. Government work and is in the public domain in the USA.)
- Subjects :
- Computer Simulation
Data Collection
Humans
Predictive Value of Tests
Risk Adjustment
Tissue Donors
Transplant Recipients
Graft Survival
Organ Transplantation statistics & numerical data
Program Evaluation statistics & numerical data
Registries statistics & numerical data
Statistics as Topic
Tissue and Organ Procurement statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1600-6143
- Volume :
- 19
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
- Publication Type :
- Academic Journal
- Accession number :
- 30282119
- Full Text :
- https://doi.org/10.1111/ajt.15132