Survival Analysis

Which clock should an external prognostic validation use?

by Nino Q.

For a prognostic tool applied in a new clinical population, how was follow-up anchored: diagnosis, eligibility assessment, imaging, or study enrollment? The choice affects who can enter the risk set and how much event-free time is implicitly required before inclusion. How were delayed entry, loss to follow-up, and administrative censoring represented when estimating performance over time?

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themustafa

The validation clock needs to match the risk horizon the tool predicts. Enrollment can define entry into observation without defining that horizon's origin. Does the tool predict risk from diagnosis, or remaining risk from the assessment when its inputs become available?

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