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Record W4407674404 · doi:10.1177/0272989x251314010

Expected Value of Sample Information Calculations for Risk Prediction Model Validation

2025· article· en· W4407674404 on OpenAlexafffund
Mohsen Sadatsafavi, Andrew J. Vickers, Tae Yoon Lee, Paul Gustafson, Laure Wynants

Bibliographic record

VenueMedical Decision Making · 2025
Typearticle
Languageen
FieldEconomics, Econometrics and Finance
TopicHealth Systems, Economic Evaluations, Quality of Life
Canadian institutionsCentre for Advancing Health OutcomesUniversity of British Columbia
FundersNational Cancer InstituteCanadian Institutes of Health ResearchNational Institutes of HealthMemorial Sloan-Kettering Cancer Center
KeywordsSample size determinationFalse positive paradoxStatisticsPopulationComputer scienceSample (material)ComputationEconometricsData miningMathematicsAlgorithmMedicine

Abstract

fetched live from OpenAlex

BackgroundThe purpose of external validation of a risk prediction model is to evaluate its performance before recommending it for use in a new population. Sample size calculations for such validation studies are currently based on classical inferential statistics around metrics of discrimination, calibration, and net benefit (NB). For NB as a measure of clinical utility, the relevance of inferential statistics is doubtful. Value-of-information methodology enables quantifying the value of collecting validation data in terms of expected gain in clinical utility.MethodsWe define the validation expected value of sample information (EVSI) as the expected gain in NB by procuring a validation sample of a given size. We propose 3 algorithms for EVSI computation and compare their face validity and computation time in simulation studies. In a case study, we use the non-US subset of a clinical trial to create a risk prediction model for short-term mortality after myocardial infarction and calculate validation EVSI at a range of sample sizes for the US population.ResultsComputation methods generated similar EVSI values in simulation studies, although they differed in numerical accuracy and computation times. At 2% risk threshold, procuring 1,000 observations for external validation, had an EVSI of 0.00101 in true-positive units or 0.04938 in false-positive units. Scaled by heart attack incidence in the United States, the population EVSI was 806 in true positives gained, or 39,500 in false positives averted, annually. Validation studies with >4,000 observations had diminishing returns, as the EVSIs were approaching their maximum possible value.ConclusionValue-of-information methodology quantifies the return on investment from conducting an external validation study and can provide a value-based perspective when designing such studies.HighlightsIn external validation studies of risk prediction models, the finite size of the validation sample leads to uncertain conclusions about the performance of the model. This uncertainty has hitherto been approached from a classical inferential perspective (e.g., confidence interval around the c-statistic).Correspondingly, sample size calculations for validation studies have been based on classical inferential statistics. For measures of clinical utility such as net benefit, the relevance of this approach is doubtful.This article defines the expected value of sample information (EVSI) for model validation and suggests algorithms for its computation. Validation EVSI quantifies the return on investment from conducting a validation study.Value-based approaches rooted in decision theory can complement contemporary study design and sample size calculation methods in predictive analytics.

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How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.011
metaresearch head score (Gemma)0.053
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Simulation or modeling · Consensus signal: none
GenreCandidate signal: Methods · Consensus signal: none
Teacher disagreement score0.775
Threshold uncertainty score0.955

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0110.053
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0010.000
Science and technology studies0.0000.000
Scholarly communication0.0000.001
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.208
GPT teacher head0.458
Teacher spread0.250 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designSimulation or modeling
Domainnot available
GenreMethods

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations4
Published2025
Admission routes2
Has abstractyes

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