Validity of prognostic models of critical COVID-19 is variable. A systematic review with external validation
Author
Publication date
2023-07Abstract
Objectives
To identify prognostic models which estimate the risk of critical COVID-19 in hospitalized patients and to assess their validation properties.
Study Design and Setting
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, 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).
Results
We validated 18 prognostic models. Discrimination was good in nine of them (AUCs ≥ 80%) and higher in those predicting mortality (AUCs 65%–87%) than those predicting intensive care unit admission or a composite outcome (AUCs 53%–78%). Calibration was poor in all models providing outcome's probabilities and good in four 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.
Conclusion
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.
Document Type
Article
Document version
Published version
Language
English
Keywords
COVID-19 (Malaltia)
Malaltia crítica
Unitats de cures intensives
Prognosi
Validació externa
Epidemiologia
Pages
15 p.
Publisher
Elsevier
Is part of
Journal of Clinical Epidemiology, 2023, 159: 274-288
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Rights
© L'autor/a
Except where otherwise noted, this item's license is described as http://creativecommons.org/licenses/by-nc-nd/4.0/