Prognostic models for intracerebral hemorrhage: systematic review and meta-analysis

• Tipo: Artigo em Revista Científica Internacional
• Data: 2018

Autores

Gregorio, T (Autor) Outra; Pipa, S (Autor) Outra; Cavaleiro, P (Autor) Outra; Atanasio, G (Autor) Outra; Albuquerque, I (Autor) Outra; Castro-Chaves P (Autor) FMUP; Azevedo L (Autor) FMUP

Revista

Título: BMC Medical Research Methodology

Vol. 18

ISSN: 1471-2288

Editora: Springer Nature

Indexação

ISI Web of Knowledge - 56 Citações

Scopus - 44 Citações

Outras Informações

ID Authenticus: P-00P-WPN

DOI: 10.1186/s12874-018-0613-8

Abstract (EN): BackgroundPrognostic tools for intracerebral hemorrhage (ICH) patients are potentially useful for ascertaining prognosis and recommended in guidelines to facilitate streamline assessment and communication between providers. In this systematic review with meta-analysis we identified and characterized all existing prognostic tools for this population, performed a methodological evaluation of the conducting and reporting of such studies and compared different methods of prognostic tool derivation in terms of discrimination for mortality and functional outcome prediction.MethodsPubMed, ISI, Scopus and CENTRAL were searched up to 15th September 2016, with additional studies identified using reference check. Two reviewers independently extracted data regarding the population studied, process of tool derivation, included predictors and discrimination (c statistic) using a predesignated spreadsheet based in the CHARMS checklist. Disagreements were solved by consensus. C statistics were pooled using robust variance estimation and meta-regression was applied for group comparisons using random effect models.ResultsFifty nine studies were retrieved, including 48,133 patients and reporting on the derivation of 72 prognostic tools. Data on discrimination (c statistic) was available for 53 tools, 38 focusing on mortality and 15 focusing on functional outcome. Discrimination was high for both outcomes, with a pooled c statistic of 0.88 for mortality and 0.87 for functional outcome. Forty three tools were regression based and nine tools were derived using machine learning algorithms, with no differences found between the two methods in terms of discrimination (p=0.490). Several methodological issues however were identified, relating to handling of missing data, low number of events per variable, insufficient length of follow-up, absence of blinding, infrequent use of internal validation, and underreporting of important model performance measures.ConclusionsPrognostic tools for ICH discriminated well for mortality and functional outcome in derivation studies but methodological issues require confirmation of these findings in validation studies. Logistic regression based risk scores are particularly promising given their good performance and ease of application.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 17