In the time-to-event setting, the concordance probability assesses the relative level of agreement between a model-based risk score and the survival time of a patient. While it provides a measure of discrimination over the entire follow-up period of a study, the probability does not provide information on the longitudinal durability of a baseline risk score. It is possible that a baseline risk model is able to segregate short-term from long-term survivors but unable to maintain its discriminatory strength later in the follow-up period. As a consequence, this would motivate clinicians to re-evaluate the risk score longitudinally. This longitudinal re-evaluation may not, however, be feasible in many scenarios since a single baseline evaluation may be the only data collectible due to treatment or other clinical or ethical reasons. In these scenarios, an attenuation of the discriminatory power of the patient risk score over time would indicate decreased clinical utility and call into question whether this score should remain a prognostic tool at later time points. Working within the concordance probability paradigm, we propose a method to address this clinical scenario and evaluate the discriminatory power of a baseline derived risk score over time. The methodology is illustrated with two examples: a baseline risk score in colorectal cancer defined at the time of tumor resection, and for circulating tumor cells in metastatic prostate cancer.

中文翻译：

---

测量基线风险评分的时间预后效用。

在事件发生时间设置中，一致性概率评估基于模型的风险评分与患者生存时间之间的相对一致性水平。虽然它提供了在研究的整个随访期间的歧视衡量标准，但概率并未提供有关基线风险评分的纵向持久性的信息。基线风险模型可能能够将短期幸存者与长期幸存者分开，但无法在后续阶段的后期保持其区分力。因此，这将激励临床医生纵向重新评估风险评分。然而，这种纵向重新评估在许多情况下可能不可行，因为由于治疗或其他临床或伦理原因，单个基线评估可能是唯一可收集的数据。在这些场景中，随着时间的推移，患者风险评分的辨别力减弱将表明临床效用降低，并质疑该评分是否应在以后的时间点继续作为预后工具。在一致性概率范式内，我们提出了一种方法来解决这种临床情况并评估基线派生风险评分随时间推移的辨别力。该方法用两个例子来说明：在肿瘤切除时定义的结直肠癌的基线风险评分，以及转移性前列腺癌中循环肿瘤细胞的基线风险评分。在一致性概率范式内，我们提出了一种方法来解决这种临床情况并评估基线派生风险评分随时间推移的辨别力。该方法用两个例子来说明：在肿瘤切除时定义的结直肠癌的基线风险评分，以及转移性前列腺癌中循环肿瘤细胞的基线风险评分。在一致性概率范式内，我们提出了一种方法来解决这种临床情况并评估基线派生风险评分随时间推移的辨别力。该方法用两个例子来说明：在肿瘤切除时定义的结直肠癌的基线风险评分，以及转移性前列腺癌中循环肿瘤细胞的基线风险评分。