The agreement between the predicted risks and observed outcomes is assessed that is, the model is validated by evaluating performance measures that assess, for example, calibration and discrimination.Box 2: Bootstrap validationBootstrap validation may be used when no external cohort of patients is available. The aim is to estimate how good the performance of the prediction model developed on the development set (the original dataset) would be on a hypothetical set of new patients. A bootstrap dataset is an imitation of the original dataset and is constructed by the random sampling of patients “with replacement” (that is, a patient can be selected more than once) from the original dataset.Typically, a large number of bootstrap datasets (for example, 200) is created.
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