Dissertation (Masters) Clinical Prediction Models of Patient and Graft Survival in Kidney Transplant Recipients: A Systematic Review and Validation Study


Sunita Kaur Shah Singh


There have been an increasing number of clinical prediction models (CPM) of patient and graft survival in kidney transplant recipients (KTR). The performance of these models in Canadian KTR is unknown. The purpose of this thesis is: To systematically review CPM of patient and graft survival in KTR and externally validate CPM in a cohort of Canadian KTR. CPM were assessed for performance, bias risk and clinical usefulness. Selected CPM were externally validated in a cohort of 1,326 Canadian KTR. The results of this work shows that four of 18 studies that developed CPM were found to have a low risk of bias, were externally validated and clinically usable. CPM showed modest discrimination (c statistics: 0.67 to 0.74) and poor calibration (P values <0.001) in the validation cohort. This work highlights the importance external validation of CPM prior to implementation and using novel strategies to improve the performance of CPM.


David Naimark