{"id":"https://openalex.org/W7225316109","doi":"https://doi.org/10.1186/s41512-026-00243-w","title":"The problem of continuous endpoints for clinical decision making: a decision curve analysis approach","display_name":"The problem of continuous endpoints for clinical decision making: a decision curve analysis approach","publication_year":2026,"publication_date":"2026-11-05","ids":{"openalex":"https://openalex.org/W7225316109","doi":"https://doi.org/10.1186/s41512-026-00243-w","pmid":"https://pubmed.ncbi.nlm.nih.gov/42989425","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13737844"},"language":"en","primary_location":{"id":"doi:10.1186/s41512-026-00243-w","doi":"https://doi.org/10.1186/s41512-026-00243-w","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s41512-026-00243-w","pdf_url":"https://link.springer.com/content/pdf/10.1186/s41512-026-00243-w.pdf","source":{"id":"https://openalex.org/S4210227620","display_name":"Diagnostic and Prognostic Research","issn_l":"2397-7523","issn":["2397-7523"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","jufo-1","ki-jl-1","norway-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Diagnostic and Prognostic Research","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://link.springer.com/content/pdf/10.1186/s41512-026-00243-w.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5028389558","display_name":"Lasai Barre\u00f1ada","orcid":"https://orcid.org/0000-0001-8020-0210","observed_orcids":["https://orcid.org/0000-0001-8020-0210"]},"institutions":[{"id":"https://openalex.org/I99464096","display_name":"KU Leuven","ror":"https://ror.org/05f950310","country_code":"BE","type":"education","lineage":["https://openalex.org/I99464096"]}],"countries":["BE"],"is_corresponding":false,"raw_author_name":"Lasai Barre\u00f1ada","raw_affiliation_strings":["Department of Development and Regeneration, KU Leuven, Leuven, Belgium","Leuven Unit for Health Technology Assessment Research (LUHTAR), KU Leuven, Leuven, Belgium"],"raw_orcid":"https://orcid.org/0000-0001-8020-0210","affiliations":[{"raw_affiliation_string":"Department of Development and Regeneration, KU Leuven, Leuven, Belgium","institution_ids":["https://openalex.org/I99464096"]},{"raw_affiliation_string":"Leuven Unit for Health Technology Assessment Research (LUHTAR), KU Leuven, Leuven, Belgium","institution_ids":["https://openalex.org/I99464096"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5025886998","display_name":"Andrew Julian Vickers","orcid":"https://orcid.org/0000-0003-1525-6503","observed_orcids":["https://orcid.org/0000-0003-1525-6503"]},"institutions":[{"id":"https://openalex.org/I1334819555","display_name":"Memorial Sloan Kettering Cancer Center","ror":"https://ror.org/02yrq0923","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1334819555"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Andrew Vickers","raw_affiliation_strings":["Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA. vickersa@mskcc.org"],"raw_orcid":"https://orcid.org/0000-0003-1525-6503","affiliations":[{"raw_affiliation_string":"Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA. vickersa@mskcc.org","institution_ids":["https://openalex.org/I1334819555"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5025886998"],"corresponding_institution_ids":["https://openalex.org/I1334819555"],"apc_list":{"value":2790,"currency":"USD","value_usd":2790},"apc_paid":{"value":2790,"currency":"USD","value_usd":2790},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.79704439,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"10","issue":"1","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T14374","display_name":"Statistical Methods in Epidemiology","score":0.9106000065803528,"subfield":{"id":"https://openalex.org/subfields/2613","display_name":"Statistics and Probability"},"field":{"id":"https://openalex.org/fields/26","display_name":"Mathematics"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},"topics":[{"id":"https://openalex.org/T14374","display_name":"Statistical Methods in Epidemiology","score":0.9106000065803528,"subfield":{"id":"https://openalex.org/subfields/2613","display_name":"Statistics and Probability"},"field":{"id":"https://openalex.org/fields/26","display_name":"Mathematics"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T11396","display_name":"Artificial Intelligence in Healthcare","score":0.014800000004470348,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10206","display_name":"Meta-analysis and systematic reviews","score":0.013500000350177288,"subfield":{"id":"https://openalex.org/subfields/1804","display_name":"Statistics, Probability and Uncertainty"},"field":{"id":"https://openalex.org/fields/18","display_name":"Decision Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/decision-curve-analysis","display_name":"decision curve analysis","score":0.972000002861023},{"id":"https://openalex.org/keywords/continuous-outcomes","display_name":"continuous outcomes","score":0.8159999847412109},{"id":"https://openalex.org/keywords/net-benefit","display_name":"net benefit","score":0.7799999713897705},{"id":"https://openalex.org/keywords/clinical-prediction-model","display_name":"clinical prediction model","score":0.8420000076293945},{"id":"https://openalex.org/keywords/clinical-utility","display_name":"clinical utility","score":0.6209999918937683},{"id":"https://openalex.org/keywords/threshold-probability","display_name":"threshold probability","score":0.44600000977516174},{"id":"https://openalex.org/keywords/calibration-error","display_name":"calibration error","score":0.7440000176429749},{"id":"https://openalex.org/keywords/pain-relief","display_name":"analgesia","score":0.6930000185966492},{"id":"https://openalex.org/keywords/life-expectancy","display_name":"life expectancy","score":0.8619999885559082},{"id":"https://openalex.org/keywords/prostate-cancer-treatment","display_name":"prostate cancer treatment","score":0.6809999942779541},{"id":"https://openalex.org/keywords/model-ranking","display_name":"model ranking","score":0.531000018119812}],"concepts":[{"id":"https://openalex.org/C133925201","wikidata":"https://www.wikidata.org/wiki/Q188419","display_name":"Life expectancy","level":3,"score":0.6550999879837036},{"id":"https://openalex.org/C148220186","wikidata":"https://www.wikidata.org/wiki/Q7111912","display_name":"Outcome (game theory)","level":2,"score":0.6323000192642212},{"id":"https://openalex.org/C186116695","wikidata":"https://www.wikidata.org/wiki/Q5249226","display_name":"Decision analysis","level":2,"score":0.4271000027656555},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.4244999885559082},{"id":"https://openalex.org/C84839998","wikidata":"https://www.wikidata.org/wiki/Q5249245","display_name":"Decision rule","level":2,"score":0.39590001106262207},{"id":"https://openalex.org/C105795698","wikidata":"https://www.wikidata.org/wiki/Q12483","display_name":"Statistics","level":1,"score":0.37689998745918274},{"id":"https://openalex.org/C188353592","wikidata":"https://www.wikidata.org/wiki/Q450586","display_name":"Expectancy theory","level":2,"score":0.37049999833106995},{"id":"https://openalex.org/C48372109","wikidata":"https://www.wikidata.org/wiki/Q3913","display_name":"Binary number","level":2,"score":0.3677999973297119},{"id":"https://openalex.org/C33923547","wikidata":"https://www.wikidata.org/wiki/Q395","display_name":"Mathematics","level":0,"score":0.3529999852180481},{"id":"https://openalex.org/C149782125","wikidata":"https://www.wikidata.org/wiki/Q160039","display_name":"Econometrics","level":1,"score":0.33980000019073486},{"id":"https://openalex.org/C204323151","wikidata":"https://www.wikidata.org/wiki/Q905424","display_name":"Range (aeronautics)","level":2,"score":0.32269999384880066},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.30959999561309814},{"id":"https://openalex.org/C2983394010","wikidata":"https://www.wikidata.org/wiki/Q19885330","display_name":"Continuous variable","level":2,"score":0.3003000020980835},{"id":"https://openalex.org/C28901747","wikidata":"https://www.wikidata.org/wiki/Q177571","display_name":"Decision theory","level":2,"score":0.29100000858306885},{"id":"https://openalex.org/C58471807","wikidata":"https://www.wikidata.org/wiki/Q327120","display_name":"Receiver operating characteristic","level":2,"score":0.2847999930381775},{"id":"https://openalex.org/C28719098","wikidata":"https://www.wikidata.org/wiki/Q44946","display_name":"Point (geometry)","level":2,"score":0.28220000863075256},{"id":"https://openalex.org/C59594135","wikidata":"https://www.wikidata.org/wiki/Q5249242","display_name":"Decision model","level":2,"score":0.2818000018596649},{"id":"https://openalex.org/C2778112365","wikidata":"https://www.wikidata.org/wiki/Q3511065","display_name":"Sequence (biology)","level":2,"score":0.27630001306533813},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.2750000059604645},{"id":"https://openalex.org/C10515644","wikidata":"https://www.wikidata.org/wiki/Q543310","display_name":"Survival analysis","level":2,"score":0.2646999955177307},{"id":"https://openalex.org/C10184394","wikidata":"https://www.wikidata.org/wiki/Q5165491","display_name":"Continuous modelling","level":2,"score":0.26109999418258667},{"id":"https://openalex.org/C164226766","wikidata":"https://www.wikidata.org/wiki/Q7293202","display_name":"Rank (graph theory)","level":2,"score":0.2583000063896179},{"id":"https://openalex.org/C150325174","wikidata":"https://www.wikidata.org/wiki/Q4335500","display_name":"Optimal decision","level":3,"score":0.25540000200271606},{"id":"https://openalex.org/C63527458","wikidata":"https://www.wikidata.org/wiki/Q5133829","display_name":"Clinical decision support system","level":3,"score":0.2549000084400177},{"id":"https://openalex.org/C2776292839","wikidata":"https://www.wikidata.org/wiki/Q5179217","display_name":"Coverage probability","level":3,"score":0.2547000050544739}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.1186/s41512-026-00243-w","doi":"https://doi.org/10.1186/s41512-026-00243-w","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s41512-026-00243-w","pdf_url":"https://link.springer.com/content/pdf/10.1186/s41512-026-00243-w.pdf","source":{"id":"https://openalex.org/S4210227620","display_name":"Diagnostic and Prognostic Research","issn_l":"2397-7523","issn":["2397-7523"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","jufo-1","ki-jl-1","norway-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Diagnostic and Prognostic Research","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13737844","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13737844/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13737844/pdf/41512_2026_Article_243.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Diagn Progn Res","raw_type":"Text"},{"id":"pmid:42989425","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42989425","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Diagnostic and prognostic research","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.1186/s41512-026-00243-w","doi":"https://doi.org/10.1186/s41512-026-00243-w","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s41512-026-00243-w","pdf_url":"https://link.springer.com/content/pdf/10.1186/s41512-026-00243-w.pdf","source":{"id":"https://openalex.org/S4210227620","display_name":"Diagnostic and Prognostic Research","issn_l":"2397-7523","issn":["2397-7523"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","jufo-1","ki-jl-1","norway-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Diagnostic and Prognostic Research","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.8048999905586243,"display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[{"id":"https://openalex.org/F4320309468","display_name":"Memorial Sloan-Kettering Cancer Center","ror":"https://ror.org/02yrq0923"},{"id":"https://openalex.org/F4320321730","display_name":"Fonds Wetenschappelijk Onderzoek","ror":"https://ror.org/03qtxy027"},{"id":"https://openalex.org/F4320327336","display_name":"Vlaamse regering","ror":null},{"id":"https://openalex.org/F4320332161","display_name":"National Institutes of Health","ror":"https://ror.org/01cwqze88"},{"id":"https://openalex.org/F4320337351","display_name":"National Cancer Institute","ror":"https://ror.org/040gcmg81"}],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7225316109.pdf","grobid_xml":"https://content.openalex.org/works/W7225316109.grobid-xml"},"referenced_works_count":20,"referenced_works":["https://openalex.org/W2023732110","https://openalex.org/W2026901643","https://openalex.org/W2045030989","https://openalex.org/W2071197092","https://openalex.org/W2074950591","https://openalex.org/W2115709314","https://openalex.org/W2119910794","https://openalex.org/W2129611051","https://openalex.org/W2138955176","https://openalex.org/W2146719470","https://openalex.org/W2152425345","https://openalex.org/W2166339706","https://openalex.org/W2226880313","https://openalex.org/W2417116130","https://openalex.org/W2523307075","https://openalex.org/W2900979970","https://openalex.org/W3043489240","https://openalex.org/W4244461007","https://openalex.org/W4394857110","https://openalex.org/W4417296978"],"related_works":["https://openalex.org/W7129375178","https://openalex.org/W2045030989","https://openalex.org/W7223548890","https://openalex.org/W4385719666","https://openalex.org/W7118728342","https://openalex.org/W7130309651","https://openalex.org/W2797636288","https://openalex.org/W2171448541","https://openalex.org/W4387319863","https://openalex.org/W4414148065"],"abstract_inverted_index":{"BACKGROUND:":[0],"Decision":[1],"curve":[2],"analysis":[3],"(DCA)":[4],"and":[5,92,108,255],"net":[6,114,124],"benefit":[7,125,221],"are":[8,153,205,225],"widely":[9],"used":[10],"tools":[11],"for":[12,73,127,172],"assessing":[13],"the":[14,32,61,74,101,137,146,229,235,248],"clinical":[15,43],"utility":[16,133],"of":[17,36,79,83,120,149,186,215,232,234,247,265],"prediction":[18,44,64],"models.":[19,122],"Traditional":[20],"DCA":[21,62],"is":[22,134,141,190],"applied":[23],"to":[24,63,112,163,169,220],"models":[25,45,65,107],"with":[26,66,116,136,210],"a":[27,37,71,80,84,90,128,150,157,165,200,208,251],"binary":[28,85],"endpoint,":[29],"such":[30,49],"as":[31,50],"presence":[33],"or":[34,53,222],"absence":[35],"cancer":[38,174],"on":[39,95],"biopsy.":[40],"However,":[41,123],"some":[42],"have":[46,164],"continuous":[47,67,75,129,151,243],"outcomes,":[48],"life":[51,167,202],"expectancy":[52,168,203],"pain":[54,96],"reduction":[55],"after":[56],"treatment.":[57],"METHODS:":[58],"We":[59,195,238],"extend":[60],"endpoints":[68],"by":[69],"using":[70,226],"threshold":[72,81,254],"outcome":[76,249],"in":[77,228,263],"place":[78],"probability":[82,185,214],"outcome.":[86],"RESULTS:":[87],"Through":[88],"both":[89],"simulation":[91],"case":[93],"study":[94],"reduction,":[97],"we":[98],"show":[99],"that":[100,132,160,177,240,256],"proposed":[102],"method":[103],"effectively":[104],"ranks":[105],"different":[106,121],"detects":[109],"miscalibration,":[110],"similar":[111],"traditional":[113],"benefit,":[115],"identical":[117],"rank":[118],"ordering":[119],"calculation":[126],"endpoint":[130,152],"assumes":[131],"linear":[135],"measurement":[138],"scale,":[139],"which":[140],"not":[142,216],"always":[143],"valid.":[144],"Moreover,":[145],"decision-making":[147],"implications":[148],"unclear.":[154],"For":[155],"instance,":[156],"decision":[158,257],"rule":[159,204],"patients":[161,178],"need":[162],"10-year":[166,201],"be":[170,181],"eligible":[171],"prostate":[173],"treatment":[175],"implies":[176],"should":[179],"only":[180],"treated":[182],"if":[183],"their":[184],"surviving":[187,217],"10":[188],"years":[189],"greater":[191],"than":[192],"approximately":[193,212],"50%.":[194],"question":[196],"whether":[197,223],"clinicians":[198],"implementing":[199],"comfortable":[206],"treating":[207],"patient":[209],"an":[211],"50%":[213],"long":[218],"enough":[219],"they":[224],"\"expectancy\"":[227],"lay":[230],"sense":[231],"\"most":[233],"time\".":[236],"CONCLUSIONS:":[237],"recommend":[239],"researchers":[241],"convert":[242],"predictions":[244],"into":[245],"probabilities":[246],"exceeding":[250],"clinically":[252],"relevant":[253],"makers":[258],"carefully":[259],"consider":[260],"appropriate":[261],"thresholds":[262],"light":[264],"relative":[266],"misclassification":[267],"costs.":[268]},"counts_by_year":[],"updated_date":"2026-11-09T13:22:03.289127","created_date":"2026-11-06T00:00:00"}