外伤性脊髓损伤的多变量预测模型:系统综述

IF 2.4 Q1 REHABILITATION Topics in Spinal Cord Injury Rehabilitation Pub Date : 2023-09-27 DOI:10.46292/sci23-00010
Ramtin Hakimjavadi, Shahin Basiratzadeh, Eugene K. Wai, Natalie Baddour, Stephen Kingwell, Wojtek Michalowski, Alexandra Stratton, Eve Tsai, Herna Viktor, Philippe Phan
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Using narrative synthesis, we summarized the characteristics of the included studies and their CPMs, focusing on the predictor selection process. Results We screened 663 titles and abstracts; of these, 21 full-text studies (2009-2020) consisting of 33 distinct CPMs were included. The data analysis domain was most commonly at a high risk of bias when assessed for methodological quality. Model presentation formats were inconsistently included with published CPMs; only two studies followed established guidelines for transparent reporting of multivariable prediction models. Authors frequently cited previous literature for their initial selection of predictors, and stepwise selection was the most frequent predictor selection method during modelling. Conclusion Prediction modelling studies for TSCI serve clinicians who counsel patients, researchers aiming to risk-stratify participants for clinical trials, and patients coping with their injury. 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引用次数: 1

摘要

背景外伤性脊髓损伤(Traumatic spinal cord injury, TSCI)严重影响患者及其家属的生活。预测可以改善治疗策略、卫生保健资源分配和咨询。用于预后的多变量临床预测模型(cpm)是一种可以估计结果发生的绝对风险或概率的工具。我们试图系统地回顾现有的关于TSCI cpm的文献,并严格检查所使用的预测器选择方法。方法我们检索MEDLINE、PubMed、Embase、Scopus和IEEE的英文同行评议研究和相关参考文献,这些研究开发了多变量cpm来预测成人TSCI患者以患者为中心的预后。运用叙事综合的方法,我们总结了纳入研究的特征及其cpm,重点介绍了预测因子的选择过程。结果共筛选题目和摘要663篇;其中,包括21个全文研究(2009-2020),包括33个不同的cpm。当评估方法学质量时,数据分析领域通常存在较高的偏倚风险。模型表示格式与已发布的cpm不一致;只有两项研究遵循了透明报告多变量预测模型的既定准则。作者经常引用先前的文献来初始选择预测因子,逐步选择是建模过程中最常用的预测因子选择方法。结论:TSCI预测模型研究服务于临床医生为患者提供咨询,研究人员为临床试验的参与者进行风险分层,以及患者应对损伤。数据分析方法的不严谨、不一致的透明报告以及缺乏模型表示格式是TSCI CPM研究中需要改进的重要领域。
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Multivariable Prediction Models for Traumatic Spinal Cord Injury: A Systematic Review
Background Traumatic spinal cord injuries (TSCI) greatly affect the lives of patients and their families. Prognostication may improve treatment strategies, health care resource allocation, and counseling. Multivariable clinical prediction models (CPMs) for prognosis are tools that can estimate an absolute risk or probability that an outcome will occur. Objectives We sought to systematically review the existing literature on CPMs for TSCI and critically examine the predictor selection methods used. Methods We searched MEDLINE, PubMed, Embase, Scopus, and IEEE for English peer-reviewed studies and relevant references that developed multivariable CPMs to prognosticate patient-centered outcomes in adults with TSCI. Using narrative synthesis, we summarized the characteristics of the included studies and their CPMs, focusing on the predictor selection process. Results We screened 663 titles and abstracts; of these, 21 full-text studies (2009-2020) consisting of 33 distinct CPMs were included. The data analysis domain was most commonly at a high risk of bias when assessed for methodological quality. Model presentation formats were inconsistently included with published CPMs; only two studies followed established guidelines for transparent reporting of multivariable prediction models. Authors frequently cited previous literature for their initial selection of predictors, and stepwise selection was the most frequent predictor selection method during modelling. Conclusion Prediction modelling studies for TSCI serve clinicians who counsel patients, researchers aiming to risk-stratify participants for clinical trials, and patients coping with their injury. Poor methodological rigor in data analysis, inconsistent transparent reporting, and a lack of model presentation formats are vital areas for improvement in TSCI CPM research.
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来源期刊
CiteScore
3.20
自引率
3.40%
发文量
33
期刊介绍: Now in our 22nd year as the leading interdisciplinary journal of SCI rehabilitation techniques and care. TSCIR is peer-reviewed, practical, and features one key topic per issue. Published topics include: mobility, sexuality, genitourinary, functional assessment, skin care, psychosocial, high tetraplegia, physical activity, pediatric, FES, sci/tbi, electronic medicine, orthotics, secondary conditions, research, aging, legal issues, women & sci, pain, environmental effects, life care planning
期刊最新文献
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