Evidence map›Paper›PMID 37637879›Full record

ArticleAnnals of surgery open : perspectives of surgical history, education, and clinical approaches2021

Massive Transfusion Protocol Predictive Modeling in the Modern Electronic Medical Record.

William Shihao Lao, Jessica L Poisson, Cory J Vatsaas, Christopher J Dente, Allan D Kirk, Suresh K Agarwal, Steven N Vaslef

Abstract read
In one paragraph

Article in Annals of surgery open : perspectives of surgical history, education, and clinical approaches, 2021. 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
–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. Article
  3. Time is tissue: Barriers to timely transfusion after pediatric injury.The journal of trauma and acute care surgery · 2023
    Review
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

7 authors.

William Shihao LaoFrom the Department of Surgery, Duke University Medical Center, Durham, NC.
Jessica L PoissonDepartment of Pathology, Duke University Medical Center, Durham, NC.
Cory J VatsaasFrom the Department of Surgery, Duke University Medical Center, Durham, NC.
Christopher J DenteDepartment of Surgery, Emory University School of Medicine, Atlanta, GA.
Allan D KirkFrom the Department of Surgery, Duke University Medical Center, Durham, NC.
Suresh K AgarwalFrom the Department of Surgery, Duke University Medical Center, Durham, NC.
Steven N VaslefFrom the Department of Surgery, Duke University Medical Center, Durham, NC.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: Integrate a predictive model for massive transfusion protocol (MTP) activation and delivery in the electronic medical record (EMR) using prospectively gathered data; externally validate the model and assess the accuracy and precision of the model over time. Background: The Emory model for predicting MTP using only four input variables was chosen to be integrated into our hospital's EMR to provide a real time clinical decision support tool. The continuous variable output allows for periodic re-calibration of the model to optimize sensitivity and specificity. Methods: Prospectively collected data from level 1 and 2 trauma activations were used to input heart rate, systolic blood pressure, base excess (BE) and mechanism of injury into the EMR-integrated model for predicting MTP activation and delivery. MTP delivery was defined as: 6 units of packed red blood cells/6 hours (MTP1) or 10 units in 24 hours (MTP2). The probability of MTP was reported in the EMR. ROC and PR curves were constructed at 6, 12, and 20 months to assess the adequacy of the model. Results: Data from 1162 patients were included. Areas under ROC for MTP activation, MTP1 and MTP2 delivery at 6, 12, and 20 months were 0.800, 0.821, and 0.831; 0.796, 0.861, and 0.879; and 0.809, 0.875, and 0.905 (all Conclusions: A predictive model for MTP activation and delivery was integrated into our EMR using prospectively collected data to externally validate the model. The model's performance improved over time. The ability to choose the cut-points of the ROC and PR curves due to the continuous variable output of probability of MTP allows one to optimize sensitivity or specificity.

Identifiers

PMID37637879
PMCPMC10455128

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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.