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2023

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cc-by-nc-nd (c) Bosch de Basea, Magda, et al.; Elsevier B.V., 2023
Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/208559

Validity of prognostic models of critical COVID-19 is variable. A systematic review with external validation

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https://doi.org/10.1016/j.jclinepi.2023.04.011

Abstract

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.

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COVID-19, Assistència hospitalària, Unitats de cures intensives

Subject (English)

COVID-19, Hospital care, Intensive care units

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Articles publicats en revistes (Biomedicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

Citation

BOSCH DE BASEA, Magda, et al. Validity of prognostic models of critical COVID-19 is variable. A systematic review with external validation. Journal of Clinical Epidemiology. 2023. Vol. 159, num. 274-288. ISSN 0895-4356. [consulted: 7 of August of 2026]. Available at: https://hdl.handle.net/2445/208559

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