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Development of a new predictive model for polypathological patients. The PROFUND index
Bernabeu-Wittel M, Ollero-Baturone M, Moreno-Gaviño L, Barón-Franco B, Fuertes A, Murcia-Zaragoza J, Ramos-Cantos C, Alemán A et al.. European journal of internal medicine, 2010-12-22
Topic: Risk, prevention and care in population studies
Background There is a concern about the accuracy of the available prognostic indexes when applying them to the emergent population of polypathological patients (PP). Methods To develop a 1-year mortality predictive index on PP, we developed a multicenter prospective cohort-study recruiting 1.632 PP after hospital discharge, outpatient clinics, or home hospitalization, from 33 hospitals. Potential risk factors were obtained in the 1.525 PP who completed follow-up. Each factor independently associated with mortality in the derivation cohort (757 PP from western hospitals) was assigned a weight, and risk scores were calculated by adding the points of each factor. Accuracy was assessed in the validation cohort (768 PP from eastern hospitals) by risk quartiles calibration, and discrimination power, by ROC curves. Finally, accuracy of the index was compared with that of the Charlson index. Results Mortality in the derivation/validation cohorts was 35%/39.5%, respectively. Nine independent mortality predictors were identified to create the index (age ≥85 years, 3 points; No caregiver or caregiver other than spouse, 2 points; active neoplasia, 6 points; dementia, 3 points; III-IV functional class on NYHA and/or MRC, 3 points; delirium during last hospital admission, 3 points; hemoglobinemia <10 g/dl, 3 points; Barthel index <60 points, 4 points; ≥4 hospital admissions in last 12 months, 3 points). Mortality in the derivation/validation cohorts was 12.1%/14.6% for patients with 0-2 points; 21.5%/31.5% for those with 3-6 points; 45%/50% for those with 7-10 points; and 68%/61.3% for those with ≥11 points, respectively. Calibration was good in derivation/validation cohorts, and discrimination power by area under the curve was 0.77/0.7. Calibration of the Charlson index was good, but discrimination power was suboptimal (area under the curve, 0.59). Conclusions This prognostic index provides an accurate and transportable method of stratifying 1-year death risk in PP.
Key findings
- Each factor independently associated with mortality in the derivation cohort (757 PP from western hospitals) was assigned a weight, and risk scores were calculated by adding the points of each factor.
- Finally, accuracy of the index was compared with that of the Charlson index.
- Results Mortality in the derivation/validation cohorts was 35%/39.5%, respectively.
Study details
- Study designprospective cohort
- Effect size39.5%; 12.1%; 14.6%
- Evidence strengthModerate
How this study scored 56/100
Published in a peer-reviewed journal, and it is a prospective cohort study, followed forward from enrollment. Scored zero for sample size, studied in people and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record and institution's track record, so those were left out: it earned 34 of the 61 points we could judge it on, which is 56 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (European journal of internal medicine) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 7 / 12 | A prospective cohort study, followed forward from enrollment |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2011 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | 2 / 3 | PubMed indexes it as a multicentre study |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 21570654) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 34 / 61 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 34 of the 61 points we could judge it on is 56 out of 100. |
| Total | 56 / 100 | — |
What each of these 20 components measures, and what this score is not →
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Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Bernabeu-Wittel, M., Ollero-Baturone, M., Moreno-Gaviño, L., Barón-Franco, B., Fuertes, A., Murcia-Zaragoza, J., et al. (2011). Development of a new predictive model for polypathological patients. The PROFUND index. European journal of internal medicine. https://doi.org/10.1016/j.ejim.2010.11.012
Vancouver
Bernabeu-Wittel M, Ollero-Baturone M, Moreno-Gaviño L, Barón-Franco B, Fuertes A, Murcia-Zaragoza J, et al. Development of a new predictive model for polypathological patients. The PROFUND index. European journal of internal medicine. 2011. doi:10.1016/j.ejim.2010.11.012. PMID: 21570654.
BibTeX
@article{bernabeuwittel2011-21570654,
author = {Bernabeu-Wittel, M. and Ollero-Baturone, M. and Moreno-Gaviño, L. and Barón-Franco, B. and Fuertes, A. and Murcia-Zaragoza, J. and Ramos-Cantos, C. and Alemán, A. and others},
title = {{Development of a new predictive model for polypathological patients. The PROFUND index}},
journal = {European journal of internal medicine},
year = {2011},
doi = {10.1016/j.ejim.2010.11.012},
pmid = {21570654},
url = {https://doi.org/10.1016/j.ejim.2010.11.012}
}
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