SynthesisBMC medical research methodology2023
Sample size requirements are not being considered in studies developing prediction models for binary outcomes: a systematic review.
Synthesis in BMC medical research methodology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
59 citing papers in PubMed, 3 syntheses or guidelines pooled it.
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- Prognostic models for prediction of perioperative allogeneic red blood cell transfusion in adult cardiac surgery: A systematic review and meta-analysis.Transfusion · 2025Pooled it
- Metabolic Risk Predictors Associated With the Onset of Vascular Complications Among Patients With Type 2 Diabetes in Zambia: A Retrospective Statistical Modeling Study.Health science reports · 2026Article
- Predicting Psychological Flourishing Among Psychologists: Integrating Self-Compassion, Traditional Regression, and Machine Learning Approaches.Healthcare (Basel, Switzerland) · 2026Article
- Limited Predictability of Traumatic Intracranial Hemorrhage from Routine Pre-CT Clinical Variables in Older Adults with Low-Energy Falls: A Systematic Benchmarking Study in a Retrospective Bicentric Cohort.Diagnostics (Basel, Switzerland) · 2026Article
- Externally validated yet undertrained: sample size deficits in machine learning-based radiomics.European radiology · 2026Article
- Three-year cardiovascular risk prediction among people who use cocaine or methamphetamine.Drug and alcohol dependence reports · 2026Article
- Quality-of-life attributes of chiropractic students that are significantly associated with students' sense of coherence: A cross-sectional study.The Journal of chiropractic education · 2026Article
- Article
- Adaptive Gaussian process search for simulation-based sample size estimation in clinical prediction models: validation of the pmsims R package.BMC medical research methodology · 2026Article
- Machine learning models predicting extubation success in mechanically ventilated patients: a systematic review and meta-analysis.Intensive care medicine experimental · 2026Review
- Persistent neuropathic-like pain phenotype after arthroscopic repair of massive rotator cuff tears: occurrence, associated factors, and a preoperative four-domain risk score.BMC musculoskeletal disorders · 2026Article
- Evidence-Based Strategies for Addressing Cancer- and Treatment-Related Cognitive Impairment: A Review.Biomolecules & therapeutics · 2026Review
- Real-Time Stress Experiences and Physiological and Psychological Responses Among LGBTQ+ Young Adults: Findings from the Stress and Heart Pilot Study.Sensors (Basel, Switzerland) · 2026Article
- Dynamic machine learning model integrating resting energy expenditure for predicting postoperative complications after gastrectomy for gastric cancer.Journal of cancer research and clinical oncology · 2026Article
- Traditional statistics and artificial intelligence-based prognostic models for predicting type 2 diabetes mellitus after gestational diabetes: a systematic review.Diagnostic and prognostic research · 2026Review
- A decomposition of Fisher's information to inform sample size for developing or updating fair and precise clinical prediction models - part 3: continuous outcomes.Diagnostic and prognostic research · 2026Article
- Exploratory association between multimodal AI-derived digital biomarkers and in-hospital mortality in adult patients with pneumonia: A proof-of-concept study.PLOS digital health · 2026Article
- Exploring an Intermediate Colorectal Cancer Screening Test Based on Stool Proteomics and Machine Learning for Optimizing the Selection of Patients for Colonoscopy Identified From FIT.Molecular & cellular proteomics : MCP · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
backgroundHaving an appropriate sample size is important when developing a clinical prediction model. We aimed to review how sample size is considered in studies developing a prediction model for a binary outcome.
methodsWe searched PubMed for studies published between 01/07/2020 and 30/07/2020 and reviewed the sample size calculations used to develop the prediction models. Using the available information, we calculated the minimum sample size that would be needed to estimate overall risk and minimise overfitting in each study and summarised the difference between the calculated and used sample size.
resultsA total of 119 studies were included, of which nine studies provided sample size justification (8%). The recommended minimum sample size could be calculated for 94 studies: 73% (95% CI: 63-82%) used sample sizes lower than required to estimate overall risk and minimise overfitting including 26% studies that used sample sizes lower than required to estimate overall risk only. A similar number of studies did not meet the ≥ 10EPV criteria (75%, 95% CI: 66-84%). The median deficit of the number of events used to develop a model was 75 [IQR: 234 lower to 7 higher]) which reduced to 63 if the total available data (before any data splitting) was used [IQR:225 lower to 7 higher]. Studies that met the minimum required sample size had a median c-statistic of 0.84 (IQR:0.80 to 0.9) and studies where the minimum sample size was not met had a median c-statistic of 0.83 (IQR: 0.75 to 0.9). Studies that met the ≥ 10 EPP criteria had a median c-statistic of 0.80 (IQR: 0.73 to 0.84).
conclusionsPrediction models are often developed with no sample size calculation, as a consequence many are too small to precisely estimate the overall risk. We encourage researchers to justify, perform and report sample size calculations when developing a prediction model.
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What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.