Evidence map›Paper›PMID 34568827›Full record

ArticleSchizophrenia bulletin open2021

Development and Validation of a Nonremission Risk Prediction Model in First-Episode Psychosis: An Analysis of 2 Longitudinal Studies.

Samuel P Leighton, Rajeev Krishnadas, Rachel Upthegrove, Steven Marwaha, Ewout W Steyerberg, Georgios V Gkoutos, Matthew R Broome, Peter F Liddle, Linda Everard, Swaran P Singh and 13 more

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In one paragraph

Article in Schizophrenia bulletin open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

23 authors.

Samuel P LeightonInstitute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Rajeev KrishnadasInstitute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK.
Rachel UpthegroveInstitute for Mental Health, University of Birmingham, Birmingham, UK.
Steven MarwahaInstitute for Mental Health, University of Birmingham, Birmingham, UK.
Ewout W SteyerbergFaculty of Medicine, University of Leiden, Leiden, Netherlands.
Georgios V GkoutosInstitute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK.
Matthew R BroomeInstitute for Mental Health, University of Birmingham, Birmingham, UK.
Peter F LiddleInstitute of Mental Health, University of Nottingham, Nottingham, UK.
Linda EverardThe Barberry, Birmingham, UK.
Swaran P SinghMental Health and Wellbeing, University of Warwick, Coventry, UK.
Nicholas FreemantleComprehensive Trials Unit, University College London, London, UK.
David FowlerSchool of Psychology, University of Sussex, Brighton, UK.
Peter B JonesWolfson College, University of Cambridge, Cambridge, UK.
Vimal SharmaDepartment of Health and Social Care, University of Chester, Chester, UK.
Robin MurrayInstitute of Psychiatry, King's College London, London, UK.
Til WykesInstitute of Psychiatry, King's College London, London, UK.
Richard J DrakeDivision of Psychology and Mental Health, University of Manchester, Manchester, UK.ORCID https://orcid.org/0000-0003-0220-4835
Iain BuchanInstitute of Population Health Sciences, University of Liverpool, Liverpool, UK.
Simon RogersSchool of Computing Science, University of Glasgow, Glasgow, UK.ORCID https://orcid.org/0000-0003-3578-4477
Jonathan CavanaghInstitute of Infection, Immunity and Inflammation, University of Glasgow, Birmingham, UK.
Shon W LewisDivision of Psychology and Mental Health, University of Manchester, Manchester, UK.
Max BirchwoodMental Health and Wellbeing, University of Warwick, Coventry, UK.
Pavan K MallikarjunInstitute for Mental Health, University of Birmingham, Birmingham, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Psychosis is a major mental illness with first onset in young adults. The prognosis is poor in around half of the people affected, and difficult to predict. The few tools available to predict prognosis have major weaknesses which limit their use in clinical practice. We aimed to develop and validate a risk prediction model of symptom nonremission in first-episode psychosis. Our development cohort consisted of 1027 patients with first-episode psychosis recruited between 2005 and 2010 from 14 early intervention services across the National Health Service in England. Our validation cohort consisted of 399 patients with first-episode psychosis recruited between 2006 and 2009 from a further 11 English early intervention services. The one-year nonremission rate was 52% and 54% in the development and validation cohorts, respectively. Multivariable logistic regression was used to develop a risk prediction model for nonremission, which was externally validated. The prediction model showed good discrimination C-statistic of 0.73 (0.71, 0.75) and adequate calibration with intercept alpha of 0.12 (0.02, 0.22) and slope beta of 0.98 (0.85, 1.11). Our model improved the net-benefit by 15% at a risk threshold of 50% compared to the strategy of treating all, equivalent to 15 more detected nonremitted first-episode psychosis individuals per 100 without incorrectly classifying remitted cases. Once prospectively validated, our first episode psychosis prediction model could help identify patients at increased risk of nonremission at initial clinical contact.

Indexed as

early interventionlogistic regressionprecision medicineprognosispsychotic disordersschizophrenia

Identifiers

PMID34568827
PMCPMC8458108

What OpenQuestion holds

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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.