Methodological quality of multivariate prognostic models for intracranial haemorrhages in intensive care units: a systematic review
Objectives Patients with severe spontaneous intracranial haemorrhages, managed in intensive care units, face ethical issues regarding the difficulty of anticipating their recovery. Prognostic tools help clinicians in counselling patients and relatives and guide therapeutic decisions. We aimed to met...
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BMJ Publishing Group
2021-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/11/9/e047279.full |
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| author | Denis Frasca Fanny Feuillet Maxime Leger Raphaël Cinotti Yohann Foucher Jeanne Simon-Pimmel Laetitia Bodet-Contentin Etienne Dantan |
| author_facet | Denis Frasca Fanny Feuillet Maxime Leger Raphaël Cinotti Yohann Foucher Jeanne Simon-Pimmel Laetitia Bodet-Contentin Etienne Dantan |
| author_sort | Denis Frasca |
| collection | DOAJ |
| description | Objectives Patients with severe spontaneous intracranial haemorrhages, managed in intensive care units, face ethical issues regarding the difficulty of anticipating their recovery. Prognostic tools help clinicians in counselling patients and relatives and guide therapeutic decisions. We aimed to methodologically assess prognostic tools for functional outcomes in severe spontaneous intracranial haemorrhages.Data sources Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations, we conducted a systematic review querying Medline, Embase, Web of Science, and the Cochrane in January 2020.Study selection We included development or validation of multivariate prognostic models for severe intracerebral or subarachnoid haemorrhage.Data extraction We evaluated the articles following the CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies and Transparent Reporting of multivariable prediction model for Individual Prognosis Or Diagnosis statements to assess the tools’ methodological reporting.Results Of the 6149 references retrieved, we identified 85 articles eligible. We discarded 43 articles due to the absence of prognostic performance or predictor selection. Among the 42 articles included, 22 did not validate models, 6 developed and validated models and 14 only externally validated models. When adding 11 articles comparing developed models to existing ones, 25 articles externally validated models. We identified methodological pitfalls, notably the lack of adequate validations or insufficient performance levels. We finally retained three scores predicting mortality and unfavourable outcomes: the IntraCerebral Haemorrhages (ICH) score and the max-ICH score for intracerebral haemorrhages, the SubArachnoid Haemorrhage International Trialists score for subarachnoid haemorrhages.Conclusions Although prognostic studies on intracranial haemorrhages abound in the literature, they lack methodological robustness or show incomplete reporting. Rather than developing new scores, future authors should focus on externally validating and updating existing scores with large and recent cohorts. |
| format | Article |
| id | doaj-art-24fb4f55b9bb4e6ea5e8ffd8354fbf3c |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2021-09-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-24fb4f55b9bb4e6ea5e8ffd8354fbf3c2025-08-20T02:18:11ZengBMJ Publishing GroupBMJ Open2044-60552021-09-0111910.1136/bmjopen-2020-047279Methodological quality of multivariate prognostic models for intracranial haemorrhages in intensive care units: a systematic reviewDenis Frasca0Fanny Feuillet1Maxime Leger2Raphaël Cinotti3Yohann Foucher4Jeanne Simon-Pimmel5Laetitia Bodet-Contentin6Etienne Dantan7Anesthesia and Critical Care Department, University Hospital Centre Poitiers, Poitiers, FranceUMR 1246 Methods in Patients-Centered Outcomes and Health Research, INSERM, Nantes, FranceDépartement Anesthésie Réanimation, Centre Hospitalier Universitaire d`Angers, Angers, FrancePôle Anesthésie-Réanimation, Service d’Anesthésie Réanimation Chirurgicale, Hôtel Dieu, Centre Hospitalier Universitaire de Nantes, Nantes, FranceUMR 1246 Methods in Patients-Centered Outcomes and Health Research, INSERM, Nantes, FranceUMR 1246 Methods in Patients-Centered Outcomes and Health Research, INSERM, Nantes, FranceUMR 1246 Methods in Patients-Centered Outcomes and Health Research, INSERM, Nantes, FranceUMR 1246 Methods in Patients-Centered Outcomes and Health Research, INSERM, Nantes, FranceObjectives Patients with severe spontaneous intracranial haemorrhages, managed in intensive care units, face ethical issues regarding the difficulty of anticipating their recovery. Prognostic tools help clinicians in counselling patients and relatives and guide therapeutic decisions. We aimed to methodologically assess prognostic tools for functional outcomes in severe spontaneous intracranial haemorrhages.Data sources Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations, we conducted a systematic review querying Medline, Embase, Web of Science, and the Cochrane in January 2020.Study selection We included development or validation of multivariate prognostic models for severe intracerebral or subarachnoid haemorrhage.Data extraction We evaluated the articles following the CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies and Transparent Reporting of multivariable prediction model for Individual Prognosis Or Diagnosis statements to assess the tools’ methodological reporting.Results Of the 6149 references retrieved, we identified 85 articles eligible. We discarded 43 articles due to the absence of prognostic performance or predictor selection. Among the 42 articles included, 22 did not validate models, 6 developed and validated models and 14 only externally validated models. When adding 11 articles comparing developed models to existing ones, 25 articles externally validated models. We identified methodological pitfalls, notably the lack of adequate validations or insufficient performance levels. We finally retained three scores predicting mortality and unfavourable outcomes: the IntraCerebral Haemorrhages (ICH) score and the max-ICH score for intracerebral haemorrhages, the SubArachnoid Haemorrhage International Trialists score for subarachnoid haemorrhages.Conclusions Although prognostic studies on intracranial haemorrhages abound in the literature, they lack methodological robustness or show incomplete reporting. Rather than developing new scores, future authors should focus on externally validating and updating existing scores with large and recent cohorts.https://bmjopen.bmj.com/content/11/9/e047279.full |
| spellingShingle | Denis Frasca Fanny Feuillet Maxime Leger Raphaël Cinotti Yohann Foucher Jeanne Simon-Pimmel Laetitia Bodet-Contentin Etienne Dantan Methodological quality of multivariate prognostic models for intracranial haemorrhages in intensive care units: a systematic review BMJ Open |
| title | Methodological quality of multivariate prognostic models for intracranial haemorrhages in intensive care units: a systematic review |
| title_full | Methodological quality of multivariate prognostic models for intracranial haemorrhages in intensive care units: a systematic review |
| title_fullStr | Methodological quality of multivariate prognostic models for intracranial haemorrhages in intensive care units: a systematic review |
| title_full_unstemmed | Methodological quality of multivariate prognostic models for intracranial haemorrhages in intensive care units: a systematic review |
| title_short | Methodological quality of multivariate prognostic models for intracranial haemorrhages in intensive care units: a systematic review |
| title_sort | methodological quality of multivariate prognostic models for intracranial haemorrhages in intensive care units a systematic review |
| url | https://bmjopen.bmj.com/content/11/9/e047279.full |
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