RESEARCH ARTICLE Design Characteristics Influence Performance of Clinical Prediction Rules in Validation: A Meta-Epidemiological Study

Background Many new clinical prediction rules are derived and validated. But the design and reporting quality of clinical prediction research has been less than optimal. We aimed to assess whether design characteristics of validation studies were associated with the overestimation of clinical prediction rules ’ performance. We also aimed to evaluate whether validation stud-ies clearly reported important methodological characteristics. Methods Electronic databases were searched for systematic reviews of clinical prediction rule stud-ies published between 2006 and 2010. Data were extracted from the eligible validation stud-ies included in the systematic reviews. A meta-analytic meta-epidemiological approach was used to assess the influence of design characteristics on predictive performance. From each validation study, it was assessed whether 7 design and 7 reporting characteristics were properly described. Result