Evaluation of Risk Prediction Models to Identify Cancer Therapeutics Related Cardiac Dysfunction in Women with HER2+ Breast Cancer

Figure 1. Assessment of discrimination and calibration for the three models. ROC Curve and Calibration plots for the Ezaz model (A,D). NSABP-31 CRS (B,E) and HFA-ICOS Proforma (C,F). In Panel A-C, the dotted line represents how a random classifier would perform while the solid line represents the performance of the model being evaluated. The AUCs and 95% CIs are provided as an insert. In Panel D-F, the dotted line represents perfect calibration. The red dots represent the observed risk of CTRCD of the risk groups, as defined by Ezaz model, the quintiles of NSABP-31 CRS, or HFA-ICOS Proforma, from our cohort. The red bars represent 95% CIs of the observed risks. NSABP-31 CRS, National Surgical Adjuvant Breast and Bowel Project B-31 cardiac risk score; HFA-ICOS Proforma, Heart Failure Association of the European Society of Cardiology-International Cardio-Oncology Society Proforma; AUC, area under curve; ROC Curve, receiver operating characteristic curves; CI, confidence interval.

Figure 2. (A) ROC curve and (B) calibration plots for the Ezaz model for patients aged 67 years of age and older only. Please see the caption of Figure 1 for additional information regarding the figure. AUC, area under curve; ROC Curve, receiver operating characteristic curves.

Figure 3. (A) ROC curve and (B) calibration plot for the NSABP-31 CRS with the inclusion, only, of patients who received sequential anthracycline and trastuzumab therapy. Please see the caption of Figure 1 for additional information regarding the figure. NSABP31-CRS, National Surgical Adjuvant Breast and Bowel Project B-31 cardiac risk score; AUC, area under curve; ROC Curve, receiver operating characteristic curves.

Figure 4. Discrimination (A) and calibration (B) of the HFA-ICOS proforma for patients with biomarkers (troponin and B-type natriuretic peptide). Please see the caption of Figure 1 for additional information regarding the figure. HFA-ICOS Proforma, Heart Failure Association of the European Society of Cardiology-International Cardio-Oncology Society Proforma; AUC, area under curve; ROC Curve, receiver operating characteristic curves.

Figure 5. Discrimination and calibration of the risk models using the ESC CTRCD definition. ROC curves and calibration plots for the Ezaz model (A,D), NSABP-31 CRS (B,E), and HFA-ICOS proformas (C,F). Please see the caption of Figure 1 for additional information regarding the figure. ESC, European Society of Cardiology; NSABP31-CRS, National Surgical Adjuvant Breast and Bowel Project B-31 cardiac risk score; HFA-ICOS Proforma, Heart Failure Association of the European Society of Cardiology-International Cardio-Oncology Society Proforma; AUC, area under curve; ROC Curve, receiver operating characteristic curves.

Figure 6. Discrimination and calibration of the risk modes using the ASE CTRCD definition. ROC curves and calibration plots for the Ezaz model (A,D), NSABP-31 CRS (B,E), and HFA-ICOS proformas (C,F). Please see the caption of Figure 1 for additional information regarding the figure. ASE, American Society of Echocardiography; NSABP31-CRS, National Surgical Adjuvant Breast and Bowel Project B-31 cardiac risk score; HFA-ICOS Proforma, Heart Failure Association of the European Society of Cardiology-International Cardio-Oncology Society Proforma; AUC, area under curve; ROC Curve, receiver operating characteristic curves.