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Clinical Predictive Models of Sudden Cardiac Arrest: A Survey of the Current Science and Analysis of Model Performances

BACKGROUND: More than 500 000 sudden cardiac arrests (SCAs) occur annually in the United States. Clinical predictive models (CPMs) may be helpful tools to differentiate between patients who are likely to survive or have good neurologic recovery and those who are not. However, which CPMs are most rel...

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Autores principales: Carrick, Richard T., Park, Jinny G., McGinnes, Hannah L., Lundquist, Christine, Brown, Kristen D., Janes, W. Adam, Wessler, Benjamin S., Kent, David M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7660807/
https://www.ncbi.nlm.nih.gov/pubmed/32787675
http://dx.doi.org/10.1161/JAHA.119.017625
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author Carrick, Richard T.
Park, Jinny G.
McGinnes, Hannah L.
Lundquist, Christine
Brown, Kristen D.
Janes, W. Adam
Wessler, Benjamin S.
Kent, David M.
author_facet Carrick, Richard T.
Park, Jinny G.
McGinnes, Hannah L.
Lundquist, Christine
Brown, Kristen D.
Janes, W. Adam
Wessler, Benjamin S.
Kent, David M.
author_sort Carrick, Richard T.
collection PubMed
description BACKGROUND: More than 500 000 sudden cardiac arrests (SCAs) occur annually in the United States. Clinical predictive models (CPMs) may be helpful tools to differentiate between patients who are likely to survive or have good neurologic recovery and those who are not. However, which CPMs are most reliable for discriminating between outcomes in SCA is not known. METHODS AND RESULTS: We performed a systematic review of the literature using the Tufts PACE (Predictive Analytics and Comparative Effectiveness) CPM Registry through February 1, 2020, and identified 81 unique CPMs of SCA and 62 subsequent external validation studies. Initial cardiac rhythm, age, and duration of cardiopulmonary resuscitation were the 3 most commonly used predictive variables. Only 33 of the 81 novel SCA CPMs (41%) were validated at least once. Of 81 novel SCA CPMs, 56 (69%) and 61 of 62 validation studies (98%) reported discrimination, with median c‐statistics of 0.84 and 0.81, respectively. Calibration was reported in only 29 of 62 validation studies (41.9%). For those novel models that both reported discrimination and were validated (26 models), the median percentage change in discrimination was −1.6%. We identified 3 CPMs that had undergone at least 3 external validation studies: the out‐of‐hospital cardiac arrest score (9 validations; median c‐statistic, 0.79), the cardiac arrest hospital prognosis score (6 validations; median c‐statistic, 0.83), and the good outcome following attempted resuscitation score (6 validations; median c‐statistic, 0.76). CONCLUSIONS: Although only a small number of SCA CPMs have been rigorously validated, the ones that have been demonstrate good discrimination.
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spelling pubmed-76608072020-11-17 Clinical Predictive Models of Sudden Cardiac Arrest: A Survey of the Current Science and Analysis of Model Performances Carrick, Richard T. Park, Jinny G. McGinnes, Hannah L. Lundquist, Christine Brown, Kristen D. Janes, W. Adam Wessler, Benjamin S. Kent, David M. J Am Heart Assoc Original Research BACKGROUND: More than 500 000 sudden cardiac arrests (SCAs) occur annually in the United States. Clinical predictive models (CPMs) may be helpful tools to differentiate between patients who are likely to survive or have good neurologic recovery and those who are not. However, which CPMs are most reliable for discriminating between outcomes in SCA is not known. METHODS AND RESULTS: We performed a systematic review of the literature using the Tufts PACE (Predictive Analytics and Comparative Effectiveness) CPM Registry through February 1, 2020, and identified 81 unique CPMs of SCA and 62 subsequent external validation studies. Initial cardiac rhythm, age, and duration of cardiopulmonary resuscitation were the 3 most commonly used predictive variables. Only 33 of the 81 novel SCA CPMs (41%) were validated at least once. Of 81 novel SCA CPMs, 56 (69%) and 61 of 62 validation studies (98%) reported discrimination, with median c‐statistics of 0.84 and 0.81, respectively. Calibration was reported in only 29 of 62 validation studies (41.9%). For those novel models that both reported discrimination and were validated (26 models), the median percentage change in discrimination was −1.6%. We identified 3 CPMs that had undergone at least 3 external validation studies: the out‐of‐hospital cardiac arrest score (9 validations; median c‐statistic, 0.79), the cardiac arrest hospital prognosis score (6 validations; median c‐statistic, 0.83), and the good outcome following attempted resuscitation score (6 validations; median c‐statistic, 0.76). CONCLUSIONS: Although only a small number of SCA CPMs have been rigorously validated, the ones that have been demonstrate good discrimination. John Wiley and Sons Inc. 2020-08-13 /pmc/articles/PMC7660807/ /pubmed/32787675 http://dx.doi.org/10.1161/JAHA.119.017625 Text en © 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Carrick, Richard T.
Park, Jinny G.
McGinnes, Hannah L.
Lundquist, Christine
Brown, Kristen D.
Janes, W. Adam
Wessler, Benjamin S.
Kent, David M.
Clinical Predictive Models of Sudden Cardiac Arrest: A Survey of the Current Science and Analysis of Model Performances
title Clinical Predictive Models of Sudden Cardiac Arrest: A Survey of the Current Science and Analysis of Model Performances
title_full Clinical Predictive Models of Sudden Cardiac Arrest: A Survey of the Current Science and Analysis of Model Performances
title_fullStr Clinical Predictive Models of Sudden Cardiac Arrest: A Survey of the Current Science and Analysis of Model Performances
title_full_unstemmed Clinical Predictive Models of Sudden Cardiac Arrest: A Survey of the Current Science and Analysis of Model Performances
title_short Clinical Predictive Models of Sudden Cardiac Arrest: A Survey of the Current Science and Analysis of Model Performances
title_sort clinical predictive models of sudden cardiac arrest: a survey of the current science and analysis of model performances
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7660807/
https://www.ncbi.nlm.nih.gov/pubmed/32787675
http://dx.doi.org/10.1161/JAHA.119.017625
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