SynthesisJournal of neuroengineering and rehabilitation2025
Prediction models for functional outcomes in prolonged disorders of consciousness: a systematic review and meta-analysis.
Synthesis in Journal of neuroengineering and rehabilitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Dynamic Global and Local Enhancement of Theta-Band Functional Networks as Neural Markers of Spinal Cord Stimulation Efficacy in Disorders of Consciousness.CNS neuroscience & therapeutics · 2026Article
- Development and validation of a prediction model for 6-month early death in pediatric H3K27M-mutant diffuse intrinsic pontine glioma (DIPG).Translational pediatrics · 2026Article
- Advances in biomarkers for diagnosing and prognosticating disorders of consciousness.Frontiers in neuroscience · 2026Review
- Neurophysiological predictors of full clinical consciousness recovery in patients with DoC: a retrospective evaluation of the DoC-NP Score.Frontiers in neurologyArticle
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Authors and funding
11 authors.
Funding
Abstract
backgroundPrecise prognostication of functional outcomes in individuals with prolonged disorders of consciousness (PDOC) is crucial for clinical decision-making. We systematically reviewed and meta-analyzed prognostic models for functional outcomes, as well as promising prognostic factors in PDOC.
methodsWe conducted a TRIPOD-SRMA-compliant systematic review, searching four databases through July 15, 2024. Risk of bias (ROB) was assessed by Prediction Model Risk of Bias Assessment Tool. Pooled sensitivity, specificity and the area under the summary receiver operating characteristic curve (SROC-AUC) were calculated based on outcome classifications (consciousness recovery, consciousness improvement, and favorable prognosis) and modality types (neurophysiological and demographic & clinical). Candidate predictors were ranked across studies, and promising factors were identified from models with both sensitivity and specificity exceeding 80%.
results38 studies comprising 54 prognostic models were included in the systematic review, and 20 models from 19 studies were included in the meta-analysis. None of the included studies were assessed as having a low ROB. The overall pooled sensitivity was 82% (95% CI: 75-87%) and specificity was 85% (95% CI: 80-89%). The pooled SROC-AUC was 0.875 (95% CI: 0.842-0.911). Neurophysiological models demonstrated higher sensitivity. Both sensitivity and specificity exceeded 80% in predicting consciousness improvement but not in consciousness recovery or favorable prognosis. Male sex, minimally conscious state, and traumatic etiology indicated better outcomes, whereas no specific neurophysiological factor could be confirmed due to heterogeneity across studies. Most studies reported limited model performance metrics, especially clinical utility.
conclusionsAlthough neurophysiological factors improve prognostic sensitivity, models' clinical impact remains limited without external validation. Future work must enhance clinical translation through more rigorous model development and validation.
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