Evidence map›Paper›PMID 29200079›Full record

Observational studyThe journal of trauma and acute care surgery2018

External validation of a smartphone app model to predict the need for massive transfusion using five different definitions.

E I Hodgman, M W Cripps, M J Mina, E M Bulger, M A Schreiber, K J Brasel, M J Cohen, P Muskat, J G Myers, L H Alarcon and 8 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The journal of trauma and acute care surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
  4. Article
  5. Article
  6. Article
  7. Review
  8. Review
  9. Review
  10. Massive Transfusion Protocol Predictive Modeling in the Modern Electronic Medical Record.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2021
    Article
  11. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

E I HodgmanFrom the Division of Burns, Trauma and Critical Care, Department of Surgery (E.H., M.C., H.P.), University of Texas at Southwestern Medical Center, Dallas, Texas; Department of Clinical Pathology (M.M.), Harvard Medical School, Boston, Massachusetts; Division of Trauma and Critical Care, Department of Surgery (E.M.), School of Medicine, University of Washington, Seattle, Washington; Division of Trauma, Critical Care, and Acute Care Surgery (M.S.), School of Medicine, Oregon Health & Science University, Portland, Oregon; Division of Trauma and Critical Care, Department of Surgery (K.B.), Medical College of Wisconsin, Milwaukee, Wisconsin; Division of General Surgery, Department of Surgery (M.J., P.M.), School of Medicine, University of California San Francisco, San Francisco, California; Division of Trauma, Department of Surgery (J.M.), School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas; Division of Trauma and General Surgery, Department of Surgery (L.A.), School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania; Biostatistics/Epidemiology/Research Design Core (M.R., E.F., D.d.J.), Center for Clinical and Translational Sciences, Division of Epidemiology, Human Genetics, and Environmental Sciences (M.R.), School of Public Health, and Center for Translational Injury Research, Division of Acute Care Surgery, Department of Surgery (J.H., B.C., E.F., D.d.J., C.W.), Medical School, University of Texas Health Science Center at Houston, Houston, Texas.
M W Cripps
M J Mina
E M Bulger
M A Schreiber
K J Brasel
M J Cohen
P Muskat
J G Myers
L H Alarcon
M H Rahbar
J B Holcomb
B A Cotton
E E Fox
D J Del Junco
C E Wade
H A Phelan
PROMMTT Study Group

Funding

U OF TEXAS HLTH SCI CTR HOUSTON CENTER FOR CLINICAL AND TRANSLATIONAL SCIENCESUL1RR024148 · NCRR · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI MCPHERSON, DAVID D · 2006 to 2010
$27.9M
Center for Clinical and Translational Sciences (CCTS)UL1TR000371 · NCATS · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI MCPHERSON, DAVID D · 2012 to 2016
$13.4M
NCATS NIH HHS UL1 TR000371NCRR NIH HHS UL1 RR024148
6 · The paper itself

Abstract

backgroundPreviously, a model to predict massive transfusion protocol (MTP) (activation) was derived using a single-institution data set. The PRospective, Observational, Multicenter, Major Trauma Transfusion database was used to externally validate this model's ability to predict both MTP activation and massive transfusion (MT) administration using multiple MT definitions.

methodsThe app model was used to calculate the predicted probability of MTP activation or MT delivery. The five definitions of MT used were: (1) 10 units packed red blood cells (PRBCs) in 24 hours, (2) Resuscitation Intensity score ≥ 4, (3) critical administration threshold, (4) 4 units PRBCs in 4 hours; and (5) 6 units PRBCs in 6 hours. Receiver operating curves were plotted to compare the predicted probability of MT with observed outcomes.

resultsOf 1,245 patients in the data set, 297 (24%) met definition 1, 570 (47%) met definition 2, 364 (33%) met definition 3, 599 met definition 4 (49.1%), and 395 met definition 5 (32.4%). Regardless of the outcome (MTP activation or MT administration), the predictive ability of the app model was consistent: when predicting activation of the MTP, the area under the curve for the model was 0.694 and when predicting MT administration, the area under the curve ranged from 0.695 to 0.711.

conclusionRegardless of the definition of MT used, the app model demonstrates moderate ability to predict the need for MT in an external, homogenous population. Importantly, the app allows the model to be iteratively recalibrated ("machine learning") and thus could improve its predictive capability as additional data are accrued. LEVEL OF EVIDENCE: Diagnostic test study/Prognostic study, level III.

Indexed as

SmartphoneAdultBlood TransfusionFemaleHumansMaleMiddle AgedPrognosisProspective StudiesResuscitationShock, HemorrhagicTrauma CentersUnited StatesWounds and InjuriesYoung Adult

Identifiers

PMID29200079
PMCPMC5780249

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.