External validation of the Intensive Care National Audit & Research Centre (ICNARC) risk prediction model in critical care units in Scotland.
External validation of the Intensive Care National Audit & Research Centre (ICNARC) risk prediction model in critical care units in Scotland.
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DOI：
10.1186/1471-2253-14-116
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发表时间：
2014
影响因子：
2.2
通讯作者：
Rowan KM
中科院分区：
文献类型：
--
作者：
Harrison DA;Lone NI;Haddow C;MacGillivray M;Khan A;Cook B;Rowan KM
风险预测模型在重症监护中用于风险分层，总结和传达风险，支持临床决策和基准性能。然而，在可以放心使用之前，它们需要验证，理想情况下使用从不同来源独立收集的数据来开发模型。本研究的目的是验证重症监护国家审计与研究中心（ICNARC）模型使用独立收集的数据，从重症监护病房在苏格兰。数据来自苏格兰重症监护协会审计小组（SICSAG）数据库，2007年至2009年。根据需要，使用标准计算机算法对变量进行拟合和映射，以将ICNARC模型（2009年重新校准）应用于SICSAG数据。ICNARC模型的性能进行了评估的歧视，校准和整体拟合，并与急性生理学和慢性健康评价（APACHE）II模型。2007年1月1日至2009年12月31日期间，苏格兰24个成人普通重症监护室收治了29，626人。排除后，23，269名住院患者被纳入分析。ICNARC模型在区分度（c指数0.848对0.806）、校准（Hosmer-Lemeshow卡方统计量18.8对214）和总体拟合（Brier评分0.140对0.157; Shapiro R 0.652对0.621）方面优于APACHE II。模型性能在研究的三年中是一致的。使用独立收集的数据，在外部人群中验证ICNARC模型时，该模型表现良好。本文的在线版本（doi：10.1186/1471-2253-14-116）包含补充材料，可供授权用户使用。
Risk prediction models are used in critical care for risk stratification, summarising and communicating risk, supporting clinical decision-making and benchmarking performance. However, they require validation before they can be used with confidence, ideally using independently collected data from a different source to that used to develop the model. The aim of this study was to validate the Intensive Care National Audit & Research Centre (ICNARC) model using independently collected data from critical care units in Scotland. Data were extracted from the Scottish Intensive Care Society Audit Group (SICSAG) database for the years 2007 to 2009. Recoding and mapping of variables was performed, as required, to apply the ICNARC model (2009 recalibration) to the SICSAG data using standard computer algorithms. The performance of the ICNARC model was assessed for discrimination, calibration and overall fit and compared with that of the Acute Physiology And Chronic Health Evaluation (APACHE) II model. There were 29,626 admissions to 24 adult, general critical care units in Scotland between 1 January 2007 and 31 December 2009. After exclusions, 23,269 admissions were included in the analysis. The ICNARC model outperformed APACHE II on measures of discrimination (c index 0.848 versus 0.806), calibration (Hosmer-Lemeshow chi-squared statistic 18.8 versus 214) and overall fit (Brier’s score 0.140 versus 0.157; Shapiro’s R 0.652 versus 0.621). Model performance was consistent across the three years studied. The ICNARC model performed well when validated in an external population to that in which it was developed, using independently collected data. The online version of this article (doi:10.1186/1471-2253-14-116) contains supplementary material, which is available to authorized users.
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影响因子：
8.8
作者：
Harrison, David A.;Parry, Gareth J.;Rowan, Kathy
通讯作者：
Rowan, Kathy
影响因子：
38.9
作者：
Minne, Lilian;Eslami, Saeid;Abu-Hanna, Ameen
通讯作者：
Abu-Hanna, Ameen
影响因子：
9.8
作者：
Young, JD;Goldfrad, C;Rowan, K
通讯作者：
Rowan, K
影响因子：
3.1
作者：
Higgins, Thomas L
通讯作者：
Higgins, Thomas L
DOI：
10.1080/03610928008827941
发表时间：
1980-01-01
期刊：
COMMUNICATIONS IN STATISTICS PART A-THEORY AND METHODS
影响因子：
--
作者：
HOSMER, DW;LEMESHOW, S
通讯作者：
LEMESHOW, S