Ewout W. Steyerberg, PhD; Michael J. Pencina, PhD
Potential Conflicts of Interest: None disclosed.
Steyerberg EW, Pencina MJ. Reclassification Calculations for Persons With Incomplete Follow-up. Ann Intern Med. 2010;152:195-196. doi: 10.7326/0003-4819-152-3-201002020-00019
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Published: Ann Intern Med. 2010;152(3):195-196.
TO THE EDITOR:
We applaud Cook and Ridker (1) for their clear discussion of reclassification measures and recent developments in judging the incremental value of a biomarker for prediction of outcome. A key area of application is in cardiovascular disease, in which the time horizon is typically 10 years. One important problem recognized by Cook and Ridker is that not all persons will have follow-up completed until 10 years. Kaplan–Meier curves and Cox regression analysis were introduced long ago to deal with such censored observations. Reclassification measures, such as the net reclassification index (NRI) (2), have been proposed for binary data and currently have no way of incorporating incomplete follow-up. As with other model performance measures in survival analysis, reclassification statistics can be estimated at different times during follow-up.
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