Correspondence on 'Prospective predictive performance comparison between clinical gestalt and validated COVID-19 mortality scores' by Soto-Mota et al.

© American Federation for Medical Research 2021. No commercial reuse. See rights and permissions. Published by BMJ. Dear Editor, I read the article ‘Prospective predictive performance comparison between clinical gestalt and validated COVID19 mortality scores’ with great interest. The authors compared various COVID19 mortality prediction models validated in Mexican patients — LOWHARM, MSLCOVID19, NutriCoV, and neutrophiltolymphocyte ratio (NLR) —, qSOFA, and NEWS2 against clinical gestalt to predict mortality among COVID19 patients admitted to a tertiary hospital, concluding that clinical gestalt was noninferior. I would like to comment on some issues with this article. It is unclear what “clinical gestalt” meant in the study since no formal definition was provided by the authors other than study procedures. Others have defined clinical gestalt as “a physician’s unstructured estimate” or an “overall clinical impression”. Additionally, it is not clear how the authors selected the prediction models to be evaluated. They mentioned that three models validated in datasets including Mexican patients were included; however, in the absence of clear inclusion criteria, other models validated in Mexican patients could have been left out. Thus, I performed a systematic search within