Clinical Prediction Model Performance Metrics Cluster at Arbitrary Thresholds and are Incorrectly Reported in High-Ranking Journals: An Observational Meta-Research Study

Background Previous research has shown that clinical prediction models have likely been 'hacked' to meet arbitrary performance thresholds. However, this work only assessed abstracts, could not identify models with a perfect AUC (area under the receiver operating characteristic curve) of 1, and did not examine other performance metrics. Methods We collected data from full texts and validated a large language model to extract data from a random sample of Q1 journal articles for 2025. We examined if hacking occurred in the AUC value, sensitivity and specificity, and checked if articles correctly

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