Validity of prognostic models of critical COVID-19 is variable. A systematic review with external validation
Cárdenas-Fuentes, Gabriela (Barcelona Institute for Global Health (ISGlobal))
Bosch de Basea, Magda (Barcelona Institute for Global Health (ISGlobal))
Cobo, Inés (Barcelona Institute for Global Health (ISGlobal))
Subirana, Isaac (Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares)
Ceresa, Mario (Universitat Pompeu Fabra. Departament de Tecnologies de la Informació i les Comunicacions)
Famada, Ernest (Universitat Pompeu Fabra)
Gimeno-Santos, Elena (Hospital Clínic i Provincial de Barcelona)
Delgado-Ortiz, Laura (Barcelona Institute for Global Health (ISGlobal))
Faner, Rosa (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Molina-Molina, María (Institut d'Investigació Biomèdica de Bellvitge)
Agustí, Àlvar (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Muñoz Gall, Xavier (Universitat Autònoma de Barcelona. Departament de Biologia Cel·lular, de Fisiologia i d'Immunologia)
Sibila, Oriol (Hospital Clínic i Provincial de Barcelona)
Gea Guiral, Joaquim (Barcelona Respiratory Network, Barcelona, Spain)
Garcia-Aymerich, Judith (Barcelona Institute for Global Health (ISGlobal))

Data:	2023
Resum:	To identify prognostic models that estimate the risk of critical COVID-19 in hospitalised patients and to assess their validation properties. We conducted a systematic review in Medline (up to January 2021) of studies developing or updating a model that estimated the risk of critical COVID-19, defined as death, admission to intensive care unit (ICU), and/or use of mechanical ventilation during admission. Models were validated in two datasets with different backgrounds (HM [private Spanish hospital network], n=1,753, and ICS [public Catalan health system], n=1,104); by assessing discrimination (area under the curve [AUC]) and calibration (plots). We validated 18 prognostic models. Discrimination was good in 9 of them (AUCs≥80%) and higher in those predicting mortality (AUCs 65-87%) than those predicting ICU admission or a composite outcome (AUCs 53-78%). Calibration was poor in all models providing outcome's probabilities and good in 4 models providing a point-based score. These four models used mortality as outcome, and included age, oxygen saturation, and C-reactive protein among their predictors. The validity of models predicting critical COVID-19 by using only routinely collected predictors is variable. Four models showed good discrimination and calibration when externally validated and are recommended for their use.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article de revisió ; recerca ; Versió publicada
Matèria:	COVID-19 ; Critical disease ; Intensive care unit ; Prognostic models ; External validation ; Epidemiology
Publicat a:	Journal of clinical epidemiology, Vol. 159, (July 2023) , p. 274-288, ISSN 1878-5921

DOI: 10.1016/j.jclinepi.2023.04.011
PMID: 37142168

16 p, 1.1 MB

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