目的:我们系统评估经皮冠状动脉介入治疗(PCI)后患者住院和30天死亡率风险的预测模型。
方法:系统回顾和叙事综合。
方法:搜索PubMed,WebofScience,Embase,科克伦图书馆,CINAHL,CNKI,万方数据库,VIP数据库和SinoMed的文献,截至2023年8月31日。
方法:纳入的文献包括涉及年龄≥18岁PCI患者的中文或英文研究。这些研究旨在开发风险预测模型,包括队列研究等设计,病例对照研究,横断面研究或随机对照试验。每个预测模型必须至少包含两个预测因子。排除标准包括包括PCI术后死亡以外的其他结果的模型,缺乏研究设计的基本细节的文献,模型构建和统计分析,基于虚拟数据集的模型,以及会议摘要等出版物,灰色文学,非正式出版物,重复出版物,论文,审查或病例报告。我们还排除了侧重于模型的本地化适用性或比较有效性的研究。
方法:两个独立的研究团队开发了基于CHecklist的标准化数据提取表格,用于关键评估和数据提取,用于系统回顾预测建模研究,以提取和交叉验证数据。他们使用预测模型偏差风险评估工具(PROBAST)来评估本综述中包含的模型开发或验证研究的偏差风险和适用性。
结果:这篇综述包括28项研究和38个预测模型,曲线下面积值范围为0.81至0.987。一项研究有不清楚的偏见风险,虽然27项研究有很高的偏倚风险,主要是在统计分析方面。在25项研究中构建的模型缺乏临床适用性,其中21项研究包括术中或术后预测因素。
结论:PCI术后患者的院内和30天死亡率预测模型的开发还处于早期阶段。强调临床适用性和预测稳定性至关重要。未来的研究应遵循PROBAST的低偏倚风险指南,优先考虑现有模型的外部验证,以确保可靠和广泛适用的临床预测。
■CRD42023477272。
OBJECTIVE: We systematically assessed prediction models for the risk of in-hospital and 30-day mortality in post-percutaneous coronary intervention (PCI) patients.
METHODS: Systematic review and narrative synthesis.
METHODS: Searched PubMed, Web of Science, Embase, Cochrane Library, CINAHL, CNKI, Wanfang Database, VIP Database and SinoMed for literature up to 31 August 2023.
METHODS: The included literature consists of studies in Chinese or English involving PCI patients aged ≥18 years. These studies aim to develop risk prediction models and include designs such as cohort studies, case-control studies, cross-sectional studies or randomised controlled trials. Each prediction model must contain at least two predictors. Exclusion criteria encompass models that include outcomes other than death post-PCI, literature lacking essential details on study design, model construction and statistical analysis, models based on virtual datasets, and publications such as conference abstracts, grey literature, informal publications, duplicate publications, dissertations, reviews or case reports. We also exclude studies focusing on the localisation applicability of the model or comparative effectiveness.
METHODS: Two independent teams of researchers developed standardised data extraction forms based on CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies to extract and cross-verify data. They used Prediction model Risk Of Bias Assessment Tool (PROBAST) to assess the risk of bias and applicability of the model development or validation studies included in this review.
RESULTS: This review included 28 studies with 38 prediction models, showing area under the curve values ranging from 0.81 to 0.987. One study had an unclear risk of bias, while 27 studies had a high risk of bias, primarily in the area of statistical analysis. The models constructed in 25 studies lacked clinical applicability, with 21 of these studies including intraoperative or postoperative predictors.
CONCLUSIONS: The development of in-hospital and 30-day mortality prediction models for post-PCI patients is in its early stages. Emphasising clinical applicability and predictive stability is vital. Future research should follow PROBAST\'s low risk-of-bias guidelines, prioritising external validation for existing models to ensure reliable and widely applicable clinical predictions.
UNASSIGNED: CRD42023477272.