Evidence map›Paper›PMID 34158514›Full record

ArticleScientific reports2021

Prospective validation of an 11-gene mRNA host response score for mortality risk stratification in the intensive care unit.

Andrew R Moore, Jonasel Roque, Brian T Shaller, Tola Asuni, Melissa Remmel, David Rawling, Oliver Liesenfeld, Purvesh Khatri, Jennifer G Wilson, Joseph E Levitt and 2 more

Abstract readValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Scientific reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. 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

12 authors.

Andrew R MooreStanford Department of Medicine, Stanford, CA, USA.
Jonasel RoqueDivision of Pulmonary and Critical Care Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Brian T ShallerDivision of Pulmonary and Critical Care Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Tola AsuniDivision of Pulmonary and Critical Care Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Melissa RemmelInflammatix, Inc., Burlingame, CA, USA.
David RawlingInflammatix, Inc., Burlingame, CA, USA.
Oliver LiesenfeldInflammatix, Inc., Burlingame, CA, USA.
Purvesh KhatriInstitute for Immunity, Transplantation and Infections, Stanford University, Stanford, CA, USA.
Jennifer G WilsonDepartment of Emergency Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Joseph E LevittDivision of Pulmonary and Critical Care Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Timothy E SweeneyInflammatix, Inc., Burlingame, CA, USA.
Angela J RogersDivision of Pulmonary and Critical Care Medicine, Stanford University School of Medicine, Stanford, CA, USA. ajrogers@stanford.edu.

Funding

Metabolic derangements in ARDSK23HL125663 · NHLBI · STANFORD UNIVERSITY · PI ROGERS, ANGELA J · 2015 to 2018
$744k
NHLBI NIH HHS K23 HL125663
6 · The paper itself

Abstract

Several clinical calculators predict intensive care unit (ICU) mortality, however these are cumbersome and often require 24 h of data to calculate. Retrospective studies have demonstrated the utility of whole blood transcriptomic analysis in predicting mortality. In this study, we tested prospective validation of an 11-gene messenger RNA (mRNA) score in an ICU population. Whole blood mRNA from 70 subjects in the Stanford ICU Biobank with samples collected within 24 h of Emergency Department presentation were used to calculate an 11-gene mRNA score. We found that the 11-gene score was highly associated with 60-day mortality, with an area under the receiver operating characteristic curve of 0.68 in all patients, 0.77 in shock patients, and 0.98 in patients whose primary determinant of prognosis was acute illness. Subjects with the highest quartile of mRNA scores were more likely to die in hospital (40% vs 7%, p < 0.01) and within 60 days (40% vs 15%, p = 0.06). The 11-gene score improved prognostication with a categorical Net Reclassification Improvement index of 0.37 (p = 0.03) and an Integrated Discrimination Improvement index of 0.07 (p = 0.02) when combined with Simplified Acute Physiology Score 3 or Acute Physiology and Chronic Health Evaluation II score. The test performed poorly in the 95 independent samples collected > 24 h after emergency department presentation. Tests will target a 30-min turnaround time, allowing for rapid results early in admission. Moving forward, this test may provide valuable real-time prognostic information to improve triage decisions and allow for enrichment of clinical trials.

Indexed as

AgedAged, 80 and overBiomarkersEmergency Service, HospitalFemaleGene ExpressionGene Expression ProfilingHospital MortalityHumansIntensive Care UnitsMaleMiddle AgedMortalityPrognosisProspective StudiesRisk AssessmentBiomarkersRNA, Messenger

Identifiers

PMID34158514
PMCPMC8219678

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Registered trials

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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.