Pediatric prognostic models predicting inhospital child mortality in resource‐limited settings: An external validation study Article Swipe
YOU?
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· 2023
· Open Access
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· DOI: https://doi.org/10.1002/hsr2.1433
Background and Aims Prognostic models provide evidence‐based predictions and estimates of future outcomes, facilitating decision‐making, patient care, and research. A few of these models have been externally validated, leading to uncertain reliability and generalizability. This study aims to externally validate four models to assess their transferability and usefulness in clinical practice. The models include the respiratory index of severity in children (RISC)‐Malawi model and three other models by Lowlavaar et al. Methods The study used data from the Clinical Information Network (CIN) to validate the four models where the primary outcome was in‐hospital mortality. 163,329 patients met eligibility criteria. Missing data were imputed, and the logistic function was used to compute predicted risk of in‐hospital mortality. Models' discriminatory ability and calibration were determined using area under the curve (AUC), calibration slope, and intercept. Results The RISC‐Malawi model had 50,669 pneumonia patients who met the eligibility criteria, of which the case‐fatality ratio was 4406 (8.7%). Its AUC was 0.77 (95% CI: 0.77−0.78), whereas the calibration slope was 1.04 (95% CI: 1.00 −1.06), and calibration intercept was 0.81 (95% CI: 0.77−0.84). Regarding the external validation of Lowlavaar et al. models, 10,782 eligible patients were included, with an in‐hospital mortality rate of 5.3%. The primary model's AUC was 0.75 (95% CI: 0.72−0.77), the calibration slope was 0.78 (95% CI: 0.71−0.84), and the calibration intercept was 0.37 (95% CI: 0.28−0.46). All models markedly underestimated the risk of mortality. Conclusion All externally validated models exhibited either underestimation or overestimation of the risk as judged from calibration statistics. Hence, applying these models with confidence in settings other than their original development context may not be advisable. Our findings strongly suggest the need for recalibrating these model to enhance their generalizability.
Related Topics
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1002/hsr2.1433
- https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/hsr2.1433
- OA Status
- gold
- Cited By
- 3
- References
- 44
- Related Works
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- OpenAlex ID
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Raw OpenAlex JSON
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https://openalex.org/W4386225799Canonical identifier for this work in OpenAlex
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https://doi.org/10.1002/hsr2.1433Digital Object Identifier
- Title
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Pediatric prognostic models predicting inhospital child mortality in resource‐limited settings: An external validation studyWork title
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2023Year of publication
- Publication date
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2023-08-01Full publication date if available
- Authors
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Morris Ogero, John Ndiritu, Rachel Sarguta, Timothy Tuti, Samuel AkechList of authors in order
- Landing page
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https://doi.org/10.1002/hsr2.1433Publisher landing page
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/hsr2.1433Direct link to full text PDF
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goldOpen access status per OpenAlex
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/hsr2.1433Direct OA link when available
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Medicine, Generalizability theory, Logistic regression, Calibration, Case fatality rate, Statistics, Emergency medicine, Internal medicine, Epidemiology, MathematicsTop concepts (fields/topics) attached by OpenAlex
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3Total citation count in OpenAlex
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2025: 2, 2023: 1Per-year citation counts (last 5 years)
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10Other works algorithmically related by OpenAlex
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