A guide to systematic review and meta-analysis of prediction model performance

Debray TPA, Damen JAAG, Snell, KIE, Ensor J, Hooft L, Reitsma JB, Riley RD, Moons KGM

Validation of prediction models is highly recommended and increasingly common in the literature. A systematic review of validation studies is therefore helpful, with meta-analysis needed to summarise the predictive performance of the model being validated across different settings and populations. This article provides guidance for researchers systematically reviewing and meta-analysing the existing evidence on a specific prediction model, discusses good practice when quantitatively summarising the predictive performance of the model across studies, and provides recommendations for interpreting meta-analysis estimates of model performance. We present key steps of the meta-analysis and illustrate each step in an example review, by summarising the discrimination and calibration performance of the EuroSCORE for predicting operative mortality in patients undergoing coronary artery bypass grafting.