Clinical prediction models for the management of blunt chest trauma in the emergency department: a systematic review.

IF 2.3 3区 医学 Q1 EMERGENCY MEDICINE
Ceri Battle, Elaine Cole, Kym Carter, Edward Baker
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引用次数: 0

Abstract

Background: The aim of this systematic review was to investigate how clinical prediction models compare in terms of their methodological development, validation, and predictive capabilities, for patients with blunt chest trauma presenting to the Emergency Department.

Methods: A systematic review was conducted across databases from 1st Jan 2000 until 1st April 2024. Studies were categorised into three types of multivariable prediction research and data extracted regarding methodological issues and the predictive capabilities of each model. Risk of bias and applicability were assessed.

Results: 41 studies were included that discussed 22 different models. The most commonly observed study design was a single-centre, retrospective, chart review. The most widely externally validated clinical prediction models with moderate to good discrimination were the Thoracic Trauma Severity Score and the STUMBL Score.

Discussion: This review demonstrates that the predictive ability of some of the existing clinical prediction models is acceptable, but high risk of bias and lack of subsequent external validation limits the extensive application of the models. The Thoracic Trauma Severity Score and STUMBL Score demonstrate better predictive accuracy in both development and external validation studies than the other models, but require recalibration and / or update and evaluation of their clinical and cost effectiveness.

Review registration: PROSPERO database ( https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=351638 ).

急诊科处理胸部钝挫伤的临床预测模型:系统综述。
背景:本系统综述旨在研究临床预测模型在方法开发、验证和预测能力方面如何与急诊科钝性胸部创伤患者进行比较:对 2000 年 1 月 1 日至 2024 年 4 月 1 日期间的数据库进行了系统性回顾。研究分为三种类型的多变量预测研究,并提取了有关方法问题和每种模型预测能力的数据。对偏倚风险和适用性进行了评估:结果:共纳入 41 项研究,讨论了 22 种不同的模型。最常见的研究设计是单中心、回顾性、图表回顾。经外部验证的最广泛的临床预测模型是胸廓创伤严重程度评分和 STUMBL 评分,它们具有中度到良好的区分度:本综述表明,一些现有临床预测模型的预测能力是可以接受的,但高偏倚风险和缺乏后续外部验证限制了这些模型的广泛应用。胸腔创伤严重程度评分和 STUMBL 评分在开发和外部验证研究中都显示出比其他模型更好的预测准确性,但需要重新校准和/或更新,并对其临床和成本效益进行评估:PROSPERO数据库 ( https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=351638 )。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Emergency Medicine
BMC Emergency Medicine Medicine-Emergency Medicine
CiteScore
3.50
自引率
8.00%
发文量
178
审稿时长
29 weeks
期刊介绍: BMC Emergency Medicine is an open access, peer-reviewed journal that considers articles on all urgent and emergency aspects of medicine, in both practice and basic research. In addition, the journal covers aspects of disaster medicine and medicine in special locations, such as conflict areas and military medicine, together with articles concerning healthcare services in the emergency departments.
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