Development and validation of a predictive model for patients with post-extubation dysphagia

Tang, Jia-ying; Feng, Xiuqin; Huang, Xiaoxia; Zhang, Yuping; Guo, Zhiyong; Chen, Lan; Chen, Haotian; Ying, Xiao-xiao

doi:10.5847/wjem.j.1920-8642.2023.021

Cited by 3 publications

(11 citation statements)

References 24 publications

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“…44 Moreover, tube-fed nutrition causes the throat reflex to become passive, which can further worsen patients' poor swallowing function. 30 It has been found that for each hour of prolonged time the gastric tube is indwelled, and the incidence of PED increases by 33.52 times. 45 Moreover, aspiration of gastric contents is common in critically ill gastric feeding patients, and it is a major risk factor for pneumonia.…”

Section: Discussionmentioning

confidence: 99%

“…Eight of the nine included models were developed by logistic regression, 1,[19][20][21][22][30][31][32] and one was developed using the generalized additive model. 29 Of the nine models that were included, only two underwent internal validation, 19,31 while two others were subjected to external validation.…”

Section: Characteristics Of the Prediction Modelsmentioning

confidence: 99%

“…29 Of the nine models that were included, only two underwent internal validation, 19,31 while two others were subjected to external validation. 22,30 The adequacy of the sample size was evaluated based on the number of outcomes/events relative to the number of candidate predictors. Events per variable (EPV) for all models ranged from 0.5 30 to 8.9, 29 with no model having a value of more than 10.…”

Section: Characteristics Of the Prediction Modelsmentioning

confidence: 99%

“…22 Classification measures were based on varying risk cutoff values; model sensitivity ranged from 70.3% 31 to 94.34%, 30 and specificity from 68.06% 22 to 81.87%. 30 Only one model reported the overall model performance using R 2 values, which was 0.838, 20 and one model reported bias-corrected Brier scores of 0.045 19 in the training set. In the validation set, the AUC values of the two externally validated models ranged from 0.73 22 to 0.907, 30 as shown in Table II.…”

Section: Validation Of the Prediction Modelsmentioning

confidence: 99%

“…30 Only one model reported the overall model performance using R 2 values, which was 0.838, 20 and one model reported bias-corrected Brier scores of 0.045 19 in the training set. In the validation set, the AUC values of the two externally validated models ranged from 0.73 22 to 0.907, 30 as shown in Table II.…”

Section: Validation Of the Prediction Modelsmentioning

confidence: 99%

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Prediction Models for Dysphagia in Intensive Care Unit after Mechanical Ventilation: A Systematic Review and Meta‐analysis

Chen

Wang

et al. 2023

The Laryngoscope

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ObjectiveDysphagia is a common condition that can independently lead to death in patients in the intensive care unit (ICU), particularly those who require mechanical ventilation. Despite extensive research on the predictors of dysphagia development, consistency across these studies is lacking. Therefore, this study aimed to identify predictors and summarize existing prediction models for dysphagia in ICU patients undergoing invasive mechanical ventilation.MethodsWe searched five databases: PubMed, EMBASE, Web of Science, Cochrane Library, and the China National Knowledge Infrastructure. Studies that developed a post‐extubation dysphagia risk prediction model in ICU were included. A meta‐analysis of individual predictor variables was performed with mixed‐effects models. The risk of bias was assessed using the prediction model risk of bias assessment tool (PROBAST).ResultsAfter screening 1,923 references, we ultimately included nine studies in our analysis. The most commonly identified risk predictors included in the final risk prediction model were the length of indwelling endotracheal tube ≥72 h, Acute Physiology and Chronic Health Evaluation (APACHE) II score ≥15, age ≥65 years, and duration of gastric tube ≥72 h. However, PROBAST analysis revealed a high risk of bias in the performance of these prediction models, mainly because of the lack of external validation, inadequate pre‐screening of variables, and improper treatment of continuous and categorical predictors.ConclusionsThese models are particularly susceptible to bias because of numerous limitations in their development and inadequate external validation. Future research should focus on externally validating the existing model in ICU patients with varying characteristics. Moreover, assessing the acceptance and effectiveness of the model in clinical practice is needed.Level of EvidenceN/A Laryngoscope, 2023

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Section: Discussionmentioning

confidence: 99%