Evidence map›Paper›PMID 36216321›Full record

ArticleThe American journal of tropical medicine and hygiene2022

Development and Validation of a Prognostic Model and Bedside Score for the Neurological Outcome in Children with Tuberculous Meningitis.

Indar Kumar Sharawat, Aparna Ramachandran, Prateek Kumar Panda, Vinod Kumar, Poonam Sherwani, Nowneet Kumar Bhat

Open access · greenAbstract read
In one paragraph

Article in The American journal of tropical medicine and hygiene, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.5field-weighted citation impact, top 17% 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

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
  3. 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

6 authors at 1 institution.

Indar Kumar SharawatPediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India.
Aparna RamachandranDepartment of Neurology, IQRAA International Hospital and Research Centre, Kozhikode, Kerala, India.
Prateek Kumar PandaPediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India.
Vinod KumarDepartment of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India.
Poonam SherwaniDepartment of Radiodiagnosis and Imaging, All India Institute of Medical Sciences, Rishikesh, India.
Nowneet Kumar BhatDepartment of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India.
All India Institute of Medical Sciences Rishikesh

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Only a few studies have explored prognostic factors for tuberculous meningitis (TBM) in children, and an easily applicable bedside prognostic score for TBM has not been developed yet. We compared the sociodemographic, clinical, radiological, and cerebrospinal fluid parameters in the cohort of 94 TBM cases aged 1 to 18 years, with at least 6 months of completed follow-up and determined the prognostic factors associated with poor functional outcome. We assessed our proposed prognostic model using both discrimination and calibration and subsequently used the bootstrap method to validate the model internally. We finally derived an easily applicable bedside prognostic score by rounding off the regression coefficients to the nearest integers. A total of 39 (41%) and 55 (59%) patients had poor and good functional outcomes, respectively, at the end of 6 months (12 died, 13%). In multivariate analysis, a high baseline Pediatric Cerebral Performance Category (PCPC) score, brain infarction in neuroimaging, tonic motor posturing, younger age, and stage III TBM were independent predictors of poor functional outcomes. The final model showed good discrimination (area under the curve = 88.2%, P < 0.001) and good calibration (Hosmer-Lemeshow test, P = 0.53). Bootstrapping also confirmed the internal validity of this model. The PITAS (PCPC score [P], brain infarction in neuroimaging [I], tonic motor posturing [T], age [A], and stage of TBM [S]) score developed from this model has a score ranging from 0 to 12, with a higher score predicting a higher risk of poor functional outcome. The PITAS score performed better than medical research council staging alone in predicting poor functional outcomes (area under the curve = 87.1% versus 82.3%). Our study's PITAS score, developed and internally validated, has good sensitivity and specificity in predicting poor functional outcomes in pediatric TBM cases at 6 months.

Indexed as

Tuberculosis, MeningealChildHumansMultivariate AnalysisPrognosisSensitivity and Specificity

Identifiers

PMID36216321
PMCPMC9768285
OpenAlexW4304145547

What OpenQuestion holds

Textmetadata
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.