Evidence map›Paper›PMID 36233760›Full record

ArticleJournal of clinical medicine2022

A Novel Prediction Tool for Endoscopic Intervention in Patients with Acute Upper Gastro-Intestinal Bleeding.

Ido Veisman, Amit Oppenheim, Ronny Maman, Nadav Kofman, Ilan Edri, Lior Dar, Eyal Klang, Sigal Sina, Daniel Gabriely, Idan Levy and 5 more

Open access · goldAbstract read
In one paragraph

Article in Journal of clinical medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.7field-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

4 citing papers in PubMed, 10 citations in OpenAlex.

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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

15 authors at 4 institutions in 1 country.

Ido VeismanDepartment of Gastroenterology, Sheba Medical Center, Tel Hashomer, Ramat Gan 52620, Israel.
Amit OppenheimFaculty of Medicine, Tel-Aviv University, Tel Aviv 67011, Israel.
Ronny MamanFaculty of Medicine, Tel-Aviv University, Tel Aviv 67011, Israel.
Nadav KofmanFaculty of Medicine, Tel-Aviv University, Tel Aviv 67011, Israel.
Ilan EdriDepartment of Surgery, Wolfson Medical Center, Holon 5822012, Israel.
Lior DarDepartment of Gastroenterology, Sheba Medical Center, Tel Hashomer, Ramat Gan 52620, Israel.ORCID 0000-0003-1560-5910
Eyal KlangSami Sagol AI Hub, ARC, Sheba Medical Center, Tel Hashomer, Ramat Gan 52620, Israel.
Sigal SinaSami Sagol AI Hub, ARC, Sheba Medical Center, Tel Hashomer, Ramat Gan 52620, Israel.
Daniel GabrielySami Sagol AI Hub, ARC, Sheba Medical Center, Tel Hashomer, Ramat Gan 52620, Israel.
Idan LevyDepartment of Gastroenterology, Sheba Medical Center, Tel Hashomer, Ramat Gan 52620, Israel.
Dmitry BeylinFaculty of Medicine, Tel-Aviv University, Tel Aviv 67011, Israel.ORCID 0000-0002-0161-5096
Ortal BeylinFaculty of Medicine, Tel-Aviv University, Tel Aviv 67011, Israel.
Efrat ShekelFaculty of Medicine, The Hebrew University, Jerusalem 9112102, Israel.
Nir HoreshFaculty of Medicine, Tel-Aviv University, Tel Aviv 67011, Israel.
Uri KopylovDepartment of Gastroenterology, Sheba Medical Center, Tel Hashomer, Ramat Gan 52620, Israel.
Tel Aviv University · ILSheba Medical Center · ILHebrew University of Jerusalem · ILWolfson Medical Center · IL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

(1) Background: Predicting which patients with upper gastro-intestinal bleeding (UGIB) will receive intervention during urgent endoscopy can allow for better triaging and resource utilization but remains sub-optimal. Using machine learning modelling we aimed to devise an improved endoscopic intervention predicting tool. (2) Methods: A retrospective cohort study of adult patients diagnosed with UGIB between 2012−2018 who underwent esophagogastroduodenoscopy (EGD) during hospitalization. We assessed the correlation between various parameters with endoscopic intervention and examined the prediction performance of the Glasgow-Blatchford score (GBS) and the pre-endoscopic Rockall score for endoscopic intervention. We also trained and tested a new machine learning-based model for the prediction of endoscopic intervention. (3) Results: A total of 883 patients were included. Risk factors for endoscopic intervention included cirrhosis (9.0% vs. 3.8%, p = 0.01), syncope at presentation (19.3% vs. 5.4%, p < 0.01), early EGD (6.8 h vs. 17.0 h, p < 0.01), pre-endoscopic administration of tranexamic acid (TXA) (43.4% vs. 31.0%, p < 0.01) and erythromycin (17.2% vs. 5.6%, p < 0.01). Higher GBS (11 vs. 9, p < 0.01) and pre-endoscopy Rockall score (4.7 vs. 4.1, p < 0.01) were significantly associated with endoscopic intervention; however, the predictive performance of the scores was low (AUC of 0.54, and 0.56, respectively). A combined machine learning-developed model demonstrated improved predictive ability (AUC 0.68) using parameters not included in standard GBS. (4) Conclusions: The GBS and pre-endoscopic Rockall score performed poorly in endoscopic intervention prediction. An improved predictive tool has been proposed here. Further studies are needed to examine if predicting this important triaging decision can be further optimized.

Indexed as

Glasgow-Blatchford score (GBS)machine learningpre-endoscopic Rockall scoreupper GI bleeding

Identifiers

PMID36233760
PMCPMC9573673
OpenAlexW4303710196

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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.