Evidence map›Paper›PMID 34548347›Full record

SynthesisBMJ open2021

Methodological quality of multivariate prognostic models for intracranial haemorrhages in intensive care units: a systematic review.

Jeanne Simon-Pimmel, Yohann Foucher, Maxime Léger, Fanny Feuillet, Laetitia Bodet-Contentin, Raphaël Cinotti, Denis Frasca, Etienne Dantan

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
1.0field-weighted citation impact, top 21% of its field
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

6 citing papers in PubMed, 2 syntheses or guidelines pooled it, 12 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Article
  4. External validation of outcome prediction scores for aneurysmal subarachnoid hemorrhage in a real-world setting: a monocentric experience.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
    Article
  5. Article
  6. 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

8 authors at 2 institutions in 2 countries.

Jeanne Simon-PimmelUMR 1246 Methods in Patients-Centered Outcomes and Health Research, INSERM, Nantes, France Jeanne.Pimmel@gmail.com.ORCID 0000-0003-0699-5793
Yohann FoucherUMR 1246 Methods in Patients-Centered Outcomes and Health Research, INSERM, Nantes, France.
Maxime LégerUMR 1246 Methods in Patients-Centered Outcomes and Health Research, INSERM, Nantes, France.
Fanny FeuilletUMR 1246 Methods in Patients-Centered Outcomes and Health Research, INSERM, Nantes, France.
Laetitia Bodet-ContentinUMR 1246 Methods in Patients-Centered Outcomes and Health Research, INSERM, Nantes, France.
Raphaël CinottiAnaesthesia and Intensive Care Unit, Hôpital Laennec, Saint-Herblain, University Hospital of Nantes, France, Université de Nantes, CHU Nantes, Saint-Herblain, France.
Denis FrascaUMR 1246 Methods in Patients-Centered Outcomes and Health Research, INSERM, Nantes, France.
Etienne DantanUMR 1246 Methods in Patients-Centered Outcomes and Health Research, INSERM, Nantes, France.ORCID 0000-0001-7137-5051
Inserm · FRCentre Hospitalier Universitaire de Nantes · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesPatients with severe spontaneous intracranial haemorrhages, managed in intensive care units, face ethical issues regarding the difficulty of anticipating their recovery. Prognostic tools help clinicians in counselling patients and relatives and guide therapeutic decisions. We aimed to methodologically assess prognostic tools for functional outcomes in severe spontaneous intracranial haemorrhages. DATA SOURCES: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations, we conducted a systematic review querying Medline, Embase, Web of Science, and the Cochrane in January 2020. STUDY SELECTION: We included development or validation of multivariate prognostic models for severe intracerebral or subarachnoid haemorrhage. DATA EXTRACTION: We evaluated the articles following the CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies and Transparent Reporting of multivariable prediction model for Individual Prognosis Or Diagnosis statements to assess the tools' methodological reporting.

resultsOf the 6149 references retrieved, we identified 85 articles eligible. We discarded 43 articles due to the absence of prognostic performance or predictor selection. Among the 42 articles included, 22 did not validate models, 6 developed and validated models and 14 only externally validated models. When adding 11 articles comparing developed models to existing ones, 25 articles externally validated models. We identified methodological pitfalls, notably the lack of adequate validations or insufficient performance levels. We finally retained three scores predicting mortality and unfavourable outcomes: the IntraCerebral Haemorrhages (ICH) score and the max-ICH score for intracerebral haemorrhages, the SubArachnoid Haemorrhage International Trialists score for subarachnoid haemorrhages.

conclusionsAlthough prognostic studies on intracranial haemorrhages abound in the literature, they lack methodological robustness or show incomplete reporting. Rather than developing new scores, future authors should focus on externally validating and updating existing scores with large and recent cohorts.

Indexed as

Intensive Care UnitsIntracranial HemorrhagesHumansPrognosisadult intensive & critical careneurosurgerystatistics & research methodsstroke

Identifiers

PMID34548347
PMCPMC8458313
OpenAlexW3201393393

What OpenQuestion holds

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LicenceCC BY-NC
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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.