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COVID-19 research briefs: prediction models for COVID-19 have important limitations

Question clinique

What are the key predictors of a poor prognosis for patients with COVID-19?

L’Essentiel

Very limited evidence suggests that predictors of a severe prognosis in patients with COVID-19 include age, sex, features derived from computed tomography scans, C-reactive protein level, lactic dehydrogenase level, and lymphocyte count. Further details regarding specific demographics were not reported. 2c

Référence

Wynants L, Van Calster B, Bonten MM, et al. Prediction models for diagnosis and prognosis of COVID-19 infection: systematic review and critical appraisal. BMJ 2020 Apr 7;369:m1328. doi: 10.1136/bmj.m1328.

Plan de l'etude: Systematic review

Financement:

Cadre: Uncertain

Sommaire

Research Brief #7 (Wynants, 2020) In this systematic review of studies that reported diagnostic and prognostic prediction models, the authors identified 27 studies that reported 31 prediction models. Only one study took place outside of China and most were at high risk of bias. Nonetheless, the most frequently reported predictors of the presence of COVID-19 included age, body temperature, and signs and symptoms. The most reported predictors of severe prognosis (deterioration to severe or critical disease, prolonged hospitalization, or death) in patients with COVID-19 included age, sex, computed tomography findings, C-reactive protein level, lactic dehydrogenase level, and lymphocyte count. Given the high risk of bias, estimates of model accuracy are unreliable.

Reviewer

Henry C. Barry, MD, MS
Professor
Michigan State University
East Lansing, MI


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Commentaires

Anonymous

Editing, or lack thereof

This Synopsis is as useful as Woody Allen's comment after speed-reading War and Peace: "It's about some Russians." Readers could use a word or two characterizing each predictor. "Age" > is the increase in risk linear; is there an inflection point? "Temperature" > sustained, fluctuating, duration ... ? "Signs and symptoms" > honestly, what can I take from that? For anything quantifiable like CRP, LDH, lymphocyte count, try to give a number. Before you say space is limited, look at the opening sentence. There's redundancy -- "Research Brief #7 (Wynants, 2020)" -- and opportunities for editing. "In this systematic review ... the authors identified" could be "This systematic review identifies". Seven words become four. Small pleats and tucks are what line editors do. Make every word work, sweat every phrase, buy room for real information. Line editing in medical journals is abysmal, but in a space as tight as a POEM you can't slack off. You can do better.

avril 26, 2020
Anonymous

Covid19

This summary does not tell us if the criteria age,sex, crp, etc... are supposed to be high or low. We presume from other studies that age above 60, are more at risk men more than women , lymphocytes low or high? More at risk thank you

avril 26, 2020
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