Competing Risk Bias in Prognostic Models Predicting Hepatocellular Carcinoma Occurrence: Impact on Clinical Decision-making.

ABSTRACT:

Background and aims

Existing models predicting hepatocellular carcinoma (HCC) occurrence do not account for competing risk events and, thus, may overestimate the probability of HCC. Our goal was to quantify this bias for patients with cirrhosis and cured hepatitis C.

Methods

We analyzed a nationwide cohort of patients with cirrhosis and cured hepatitis C infection from Scotland. Two HCC prognostic models were developed: (1) a Cox regression model ignoring competing risk events and (2) a Fine-Gray regression model accounting for non-HCC mortality as a competing risk. Both models included the same set of prognostic factors used by previously developed HCC prognostic models. Two predictions were calculated for each patient: first, the 3-year probability of HCC predicted by mode

SUBMITTER: Innes H 

PROVIDER: S-EPMC11307513 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature