Objectives: We describe the steps for implementing a dynamic updating pipeline for clinical prediction models and illustrate the proposed methods in an application of 5-year survival prediction in cystic fibrosis.
Study Design And Setting: Dynamic model updating refers to the process of repeated updating of a clinical prediction model with new information to counter performance degradation. We describe 2 types of updating pipeline: "proactive updating" where candidate model updates are tested any time new data are available, and "reactive updating" where updates are only made when performance of the current model declines or the model structure changes.