Predicting Clinical Deterioration and Mortality at Differing Stages During Hospitalization: A Systematic Review of Risk Prediction Models in Children in Low- and Middle-Income Countries

Brink, Deborah A van den; Vries, Isabelle S A de; Datema, Myrthe; Perot, Lyric; Sommers, Ruby; Daams, Joost G.; Calis, Job C. J.; Brals, Daniëlla; Voskuijl, Wieger

doi:10.1016/j.jpeds.2023.113448

The Journal of Pediatrics

2023

DOI: 10.1016/j.jpeds.2023.113448

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Predicting Clinical Deterioration and Mortality at Differing Stages During Hospitalization: A Systematic Review of Risk Prediction Models in Children in Low- and Middle-Income Countries

Deborah A van den Brink¹,

Isabelle S A de Vries²,

Myrthe Datema³

et al.

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2024

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Cited by 5 publications

(1 citation statement)

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“…The pSOFA score on the first PICU day was previously shown to have good discrimination (area under the receiver operating characteristic curve [AUC-ROC], 0.88; 95% CI, 0.86-0.91) for predicting in-hospital mortality (8). However, only a few studies have externally validated pSOFA, and those study populations were distinct from the original quaternary care U.S. PICU population in which the score was developed (10,11).…”

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confidence: 99%

Automated Calculator for the Pediatric Sequential Organ Failure Assessment Score: Development and External Validation in a Single-Center 7-Year Cohort, 2015–2021

Akhondi-Asl,

Luchette,

Mehta

et al. 2024

Pediatric Critical Care Medicine

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OBJECTIVES: The pediatric Sequential Organ Failure Assessment (pSOFA) score summarizes severity of organ dysfunction and can be used to predict in-hospital mortality. Manual calculation of the pSOFA score is time-consuming and prone to human error. An automated method that is open-source, flexible, and scalable for calculating the pSOFA score directly from electronic health record data is desirable. DESIGN: Single-center, retrospective cohort study. SETTING: Quaternary 40-bed PICU. PATIENTS: All patients admitted to the PICU between 2015 and 2021 with ICU stay of at least 24 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We used 77 records to evaluate the automated score. The automated algorithm had an overall accuracy of 97%. The algorithm calculated the respiratory component of two cases incorrectly. An expert human annotator had an initial accuracy of 75% at the patient level and 95% at the component level. An untrained human annotator with general clinical research experience had an overall accuracy of 16% and component-wise accuracy of 67%. Weighted kappa for agreement between the automated method and the expert annotator’s initial score was 0.92 (95% CI, 0.88–0.95), and between the untrained human annotator and the automated score was 0.50 (95% CI, 0.36–0.61). Data from 9146 patients (in-hospital mortality 3.6%) were included to validate externally the discriminability of the automated pSOFA score. The admission-day pSOFA score had an area under the receiver operating characteristic curve of 0.79 (95% CI, 0.77–0.82). CONCLUSIONS: The developed automated algorithm calculates pSOFA score with high accuracy and is more accurate than a trained expert rater and nontrained data abstracter. pSOFA’s performance for predicting in-hospital mortality was lower in our cohort than it was for the originally derived score.

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confidence: 99%

Automated Calculator for the Pediatric Sequential Organ Failure Assessment Score: Development and External Validation in a Single-Center 7-Year Cohort, 2015–2021

Akhondi-Asl,

Luchette,

Mehta

et al. 2024

Pediatric Critical Care Medicine

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A research definition and framework for acute paediatric critical illness across resource-variable settings: a modified Delphi consensus

Arias,

Lintner-Rivera,

Shafi

et al. 2024

The Lancet Global Health

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Hypoxaemia and risk of death among children: rethinking oxygen saturation, risk-stratification, and the role of pulse oximetry in primary care

Graham,

King,

Duke

et al. 2024

The Lancet Global Health

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Predicting Clinical Deterioration and Mortality at Differing Stages During Hospitalization: A Systematic Review of Risk Prediction Models in Children in Low- and Middle-Income Countries

Cited by 5 publications

References 86 publications

Automated Calculator for the Pediatric Sequential Organ Failure Assessment Score: Development and External Validation in a Single-Center 7-Year Cohort, 2015–2021

Automated Calculator for the Pediatric Sequential Organ Failure Assessment Score: Development and External Validation in a Single-Center 7-Year Cohort, 2015–2021

A research definition and framework for acute paediatric critical illness across resource-variable settings: a modified Delphi consensus

Hypoxaemia and risk of death among children: rethinking oxygen saturation, risk-stratification, and the role of pulse oximetry in primary care

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