Evidence map›Paper›PMID 38266124›Full record

Observational studyBJS open2024

Long-term risk prediction after major lower limb amputation: 1-year results of the PERCEIVE study.

Brenig Llwyd Gwilym, Philip Pallmann, Cherry-Ann Waldron, Emma Thomas-Jones, Sarah Milosevic, Lucy Brookes-Howell, Debbie Harris, Ian Massey, Jo Burton, Phillippa Stewart and 9 more

Abstract readObservational Study
In one paragraph

Observational study in BJS open, 2024. 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
–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

4 citing papers in PubMed.

  1. Observational
  2. AMPREDICT Mobility-4: A Novel Four Category Mobility Outcome Prediction Model for Patients Undergoing Vascular Amputation.European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery · 2025
    Article
  3. AMPREDICT MoRe: Predicting Mortality and Re-amputation Risk after Dysvascular Amputation.European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery · 2025
    Article
  4. Comment on: "Integrating Human Intuition into Prediction Algorithms for Improved Surgical Risk Stratification".Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024
    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

19 authors.

Brenig Llwyd GwilymSchool of Medicine, Cardiff University, Cardiff, UK.ORCID 0000-0002-5403-8720
Philip PallmannCentre for Trials Research, Cardiff University, Cardiff, UK.
Cherry-Ann WaldronCentre for Trials Research, Cardiff University, Cardiff, UK.ORCID 0000-0001-8465-2492
Emma Thomas-JonesCentre for Trials Research, Cardiff University, Cardiff, UK.
Sarah MilosevicCentre for Trials Research, Cardiff University, Cardiff, UK.
Lucy Brookes-HowellCentre for Trials Research, Cardiff University, Cardiff, UK.
Debbie HarrisCentre for Trials Research, Cardiff University, Cardiff, UK.
Ian MasseyArtificial Limb and Appliance Centre, Rookwood Hospital, Cardiff and Vale University Health Board, Cardiff, UK.
Jo BurtonArtificial Limb and Appliance Centre, Rookwood Hospital, Cardiff and Vale University Health Board, Cardiff, UK.
Phillippa StewartArtificial Limb and Appliance Centre, Rookwood Hospital, Cardiff and Vale University Health Board, Cardiff, UK.
Katie SamuelDepartment of Anaesthesia, North Bristol NHS Trust, Bristol, UK.
Sian JonesC/O INVOLVE Health and Care Research Wales, Cardiff, UK.
David CoxC/O INVOLVE Health and Care Research Wales, Cardiff, UK.
Annie ClothierSchool of Medicine, Cardiff University, Cardiff, UK.
Hayley ProutCentre for Trials Research, Cardiff University, Cardiff, UK.
Adrian EdwardsDivision of Population Medicine, Cardiff University, Cardiff, UK.
Christopher P TwineBristol, Bath and Weston Vascular Network, North Bristol NHS Trust, Southmead Hospital, Bristol, UK.
David Charles BosanquetSchool of Medicine, Cardiff University, Cardiff, UK.
Vascular and Endovascular Research Network (VERN) and the PERCEIVE study group

Funding

HCRW RfPPB-19-1642
6 · The paper itself

Abstract

backgroundDecision-making when considering major lower limb amputation is complex and requires individualized outcome estimation. It is unknown how accurate healthcare professionals or relevant outcome prediction tools are at predicting outcomes at 1-year after major lower limb amputation.

methodsAn international, multicentre prospective observational study evaluating healthcare professional accuracy in predicting outcomes 1 year after major lower limb amputation and evaluation of relevant outcome prediction tools identified in a systematic search of the literature was undertaken. Observed outcomes at 1 year were compared with: healthcare professionals' preoperative predictions of death (surgeons and anaesthetists), major lower limb amputation revision (surgeons) and ambulation (surgeons, specialist physiotherapists and vascular nurse practitioners); and probabilities calculated from relevant outcome prediction tools.

resultsA total of 537 patients and 2244 healthcare professional predictions of outcomes were included. Surgeons and anaesthetists had acceptable discrimination (C-statistic = 0.715), calibration and overall performance (Brier score = 0.200) when predicting 1-year death, but performed worse when predicting major lower limb amputation revision and ambulation (C-statistics = 0.627 and 0.662 respectively). Healthcare professionals overestimated the death and major lower limb amputation revision risks. Consultants outperformed trainees, especially when predicting ambulation. Allied healthcare professionals marginally outperformed surgeons in predicting ambulation. Two outcome prediction tools (C-statistics = 0.755 and 0.717, Brier scores = 0.158 and 0.178) outperformed healthcare professionals' discrimination, calibration and overall performance in predicting death. Two outcome prediction tools for ambulation (C-statistics = 0.688 and 0.667) marginally outperformed healthcare professionals.

conclusionThere is uncertainty in predicting 1-year outcomes following major lower limb amputation. Different professional groups performed comparably in this study. Two outcome prediction tools for death and two for ambulation outperformed healthcare professionals and may support shared decision-making.

Indexed as

Amputation, SurgicalHealth PersonnelLower ExtremityConsultantsDecision Making, SharedHumans

Identifiers

PMID38266124
PMCPMC10807997

What OpenQuestion holds

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LicenceCC BY
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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.