Predicting death: an empirical evaluation of predictive tools for mortality

dc.contributor.authorSiontis, G. C.en
dc.contributor.authorTzoulaki, I.en
dc.contributor.authorIoannidis, J. P.en
dc.date.accessioned2015-11-24T18:57:25Z
dc.date.available2015-11-24T18:57:25Z
dc.identifier.issn1538-3679-
dc.identifier.urihttps://olympias.lib.uoi.gr/jspui/handle/123456789/19167
dc.rightsDefault Licence-
dc.subjectApacheen
dc.subject*Area Under Curveen
dc.subjectHumansen
dc.subjectJournal Impact Factoren
dc.subject*Mortalityen
dc.subjectPeriodicals as Topicen
dc.subject*Predictive Value of Testsen
dc.subjectPrognosisen
dc.subjectPublishingen
dc.subject*ROC Curveen
dc.titlePredicting death: an empirical evaluation of predictive tools for mortalityen
heal.abstractBACKGROUND: The ability to predict death is crucial in medicine, and many relevant prognostic tools have been developed for application in diverse settings. We aimed to evaluate the discriminating performance of predictive tools for death and the variability in this performance across different clinical conditions and studies. METHODS: We used Medline to identify studies published in 2009 that assessed the accuracy (based on the area under the receiver operating characteristic curve [AUC]) of validated tools for predicting all-cause mortality. For tools where accuracy was reported in 4 or more assessments, we calculated summary accuracy measures. Characteristics of studies of the predictive tools were evaluated to determine if they were associated with the reported accuracy of the tool. RESULTS: A total of 94 eligible studies provided data on 240 assessments of 118 predictive tools. The AUC ranged from 0.43 to 0.98 (median [interquartile range], 0.77 [0.71-0.83]), with only 23 of the assessments reporting excellent discrimination (10%) (AUC, >0.90). For 10 tools, accuracy was reported in 4 or more assessments; only 1 tool had a summary AUC exceeding 0.80. Established tools showed large heterogeneity in their performance across different cohorts (I(2) range, 68%-95%). Reported AUC was higher for tools published in journals with lower impact factor (P = .01), with larger sample size (P = .01), and for those that aimed to predict mortality among the highest-risk patients (P = .002) and among children (P < .001). CONCLUSIONS: Most tools designed to predict mortality have only modest accuracy, and there is large variability across various diseases and populations. Most proposed tools do not have documented clinical utility.en
heal.accesscampus-
heal.fullTextAvailabilityTRUE-
heal.identifier.primary10.1001/archinternmed.2011.334-
heal.identifier.secondaryhttp://www.ncbi.nlm.nih.gov/pubmed/21788535-
heal.identifier.secondaryhttp://archinte.ama-assn.org/cgi/reprint/171/19/1721.pdf-
heal.journalNameArch Intern Meden
heal.journalTypepeer-reviewed-
heal.languageen-
heal.publicationDate2011-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.typejournalArticle-
heal.type.elΆρθρο Περιοδικούel
heal.type.enJournal articleen

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