The ‘double whammy’ of low prevalence in clinical risk prediction

The ‘double whammy’ of low prevalence in clinical risk prediction
BMJ Evidence-Based Medicine Published Online First: 13 August 2021. doi: 10.1136/bmjebm-2021-111683 [NHS OpenAthens registration required]

• This article describes two principal reasons why the nature of developing clinical prediction rules in low prevalence scenarios will almost invariably result in concerns about performance, on standards by which this is usually judged. The authors focus primarily on suicide prediction, but these points apply more generally to other low prevalence clinical areas, some examples of which are also discussed.