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Systematic review of clinical prediction tools and prognostic factors in aneurysmal subarachnoid hemorrhage.

Lo BW, Fukuda H, Nishimura Y, Farrokhyar F, Thabane L, Levine MA - Surg Neurol Int (2015)

Bottom Line: Clinical prediction tools assist in clinical outcome prediction.The most frequently retained significant clinical prognostic factors for long-term neurologic outcome prediction include age, neurological grade, blood clot thickness, and aneurysm size.These include within and between study patient heterogeneity, regional variations in treatment protocols, patient referral biases, and differences in treatment, and prognosis viewpoints across different cultures.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada.

ABSTRACT

Background: Clinical prediction tools assist in clinical outcome prediction. They quantify the relative contributions of certain variables and condense information that identifies important indicators or predictors to a targeted condition. This systematic review synthesizes and critically appraises the methodologic quality of studies that derive both clinical predictors and clinical predictor tools used to determine outcome prognosis in patients suffering from aneurysmal subarachnoid hemorrhage (SAH).

Methods: This systematic review included prospective and retrospective cohort studies, and randomized controlled trials (RCTs) investigating prognostic factors and clinical prediction tools associated with determining the neurologic outcome in adult patients with aneurysmal SAH.

Results: Twenty-two studies were included in this systemic review. Independent, confounding, and outcome variables were studied. Methodologic quality of individual studies was also analyzed. Included were 3 studies analyzing databases from RCTs, 8 prospective cohort studies, and 11 retrospective cohort studies. The most frequently retained significant clinical prognostic factors for long-term neurologic outcome prediction include age, neurological grade, blood clot thickness, and aneurysm size.

Conclusions: Systematic reviews for clinical prognostic factors and clinical prediction tools in aneurysmal SAH face a number of methodological challenges. These include within and between study patient heterogeneity, regional variations in treatment protocols, patient referral biases, and differences in treatment, and prognosis viewpoints across different cultures.

No MeSH data available.


Related in: MedlinePlus

Flow diagram of study selection
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Figure 1: Flow diagram of study selection

Mentions: Investigators (BL and HF) reviewed all titles and abstracts, and full reports of all potentially relevant trials. The initial literature search (January 1, 1995 to March 31, 2014) yielded 2,863 citations [Figure 1]. Screening by title and abstract and citation yielded 121 items. Of these 121 items, reviewers BL and HF reached agreement on 70 items for inclusion, 42 items for exclusion, and were unsure on 9 items. Consensus conference was held with the assistance of a third reviewer, Yusuke Nishimura (YN). Inter-rater reliability was high (estimated kappa 0.85 (95% confidence interval [CI] 0.80–0.90) for citation and abstract screening). Seventy-nine full-text articles were identified as potentially relevant and were assessed with the further exclusion of articles due to an incomplete variable and outcome reporting, inappropriate patient inclusion and exclusion criteria, and inappropriate predictor models used.


Systematic review of clinical prediction tools and prognostic factors in aneurysmal subarachnoid hemorrhage.

Lo BW, Fukuda H, Nishimura Y, Farrokhyar F, Thabane L, Levine MA - Surg Neurol Int (2015)

Flow diagram of study selection
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4544120&req=5

Figure 1: Flow diagram of study selection
Mentions: Investigators (BL and HF) reviewed all titles and abstracts, and full reports of all potentially relevant trials. The initial literature search (January 1, 1995 to March 31, 2014) yielded 2,863 citations [Figure 1]. Screening by title and abstract and citation yielded 121 items. Of these 121 items, reviewers BL and HF reached agreement on 70 items for inclusion, 42 items for exclusion, and were unsure on 9 items. Consensus conference was held with the assistance of a third reviewer, Yusuke Nishimura (YN). Inter-rater reliability was high (estimated kappa 0.85 (95% confidence interval [CI] 0.80–0.90) for citation and abstract screening). Seventy-nine full-text articles were identified as potentially relevant and were assessed with the further exclusion of articles due to an incomplete variable and outcome reporting, inappropriate patient inclusion and exclusion criteria, and inappropriate predictor models used.

Bottom Line: Clinical prediction tools assist in clinical outcome prediction.The most frequently retained significant clinical prognostic factors for long-term neurologic outcome prediction include age, neurological grade, blood clot thickness, and aneurysm size.These include within and between study patient heterogeneity, regional variations in treatment protocols, patient referral biases, and differences in treatment, and prognosis viewpoints across different cultures.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada.

ABSTRACT

Background: Clinical prediction tools assist in clinical outcome prediction. They quantify the relative contributions of certain variables and condense information that identifies important indicators or predictors to a targeted condition. This systematic review synthesizes and critically appraises the methodologic quality of studies that derive both clinical predictors and clinical predictor tools used to determine outcome prognosis in patients suffering from aneurysmal subarachnoid hemorrhage (SAH).

Methods: This systematic review included prospective and retrospective cohort studies, and randomized controlled trials (RCTs) investigating prognostic factors and clinical prediction tools associated with determining the neurologic outcome in adult patients with aneurysmal SAH.

Results: Twenty-two studies were included in this systemic review. Independent, confounding, and outcome variables were studied. Methodologic quality of individual studies was also analyzed. Included were 3 studies analyzing databases from RCTs, 8 prospective cohort studies, and 11 retrospective cohort studies. The most frequently retained significant clinical prognostic factors for long-term neurologic outcome prediction include age, neurological grade, blood clot thickness, and aneurysm size.

Conclusions: Systematic reviews for clinical prognostic factors and clinical prediction tools in aneurysmal SAH face a number of methodological challenges. These include within and between study patient heterogeneity, regional variations in treatment protocols, patient referral biases, and differences in treatment, and prognosis viewpoints across different cultures.

No MeSH data available.


Related in: MedlinePlus