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Clinical Prediction Models in Sports Medicine: A Guide for Clinicians and Researchers.

Abstract

SYNOPSIS: Participating in sport carries inherent risk of injury. Clinicians execute high-level clinical reasoning and decision making to support athletes to achieve the best outcomes. Accurately diagnosing a problem, estimating prognosis, or selecting the most suitable intervention for each athlete is challenging. Clinical prediction models are tools to assist clinicians in estimating the risk or probability of a health outcome for an individual by using data from multiple predictors. Although common in general medical literature, clinical prediction models are rare in sports medicine. The purpose of this article was to (1) describe the steps required to develop and validate (ie, evaluate) a clinical prediction model for clinical researchers, and (2) help sports medicine clinicians understand and interpret clinical prediction model studies. Using a case study to illustrate how to implement clinical prediction models in practice, we address the following issues in developing and validating a clinical prediction model: study design and data, sample size, missing data, selecting predictors, handling continuous predictors, model fitting, internal and external validation, performance measures, reporting, and model presentation. Our work builds on initiatives to improve diagnostic and prognostic clinical research, including the PROGnosis RESearch Strategy (PROGRESS) series of papers and textbook and the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) statement. J Orthop Sports Phys Ther 2021;51(10):517-525. doi:10.2519/jospt.2021.10697.

Acceptance Date Sep 15, 2021
Publication Date Oct 1, 2021
Journal Journal of Orthopaedic and Sports Physical Therapy
Print ISSN 0190-6011
Publisher Journal of Orthopaedic and Sports Physical Therapy
Pages 517 - 525
DOI https://doi.org/10.2519/jospt.2021.10697
Keywords calibration; discrimination; miss-ing data; predictor selection; prognostic model; validation
Publisher URL https://www.jospt.org/doi/pdf/10.2519/jospt.2021.10697


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