Merijn W Bijlsma1, Matthijs C Brouwer1, Patrick M Bossuyt2, Martijn W Heymans3, Arie van der Ende4, Michael W T Tanck2, Diederik van de Beek5. 1. Department of Neurology, Center of Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. 2. Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Center of Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. 3. Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands. 4. Department of Medical Microbiology, Center of Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; The Netherlands Reference Laboratory for Bacterial Meningitis, Center of Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. 5. Department of Neurology, Center of Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: d.vandebeek@amc.uva.nl.
Abstract
OBJECTIVES: To perform an external validation study of risk scores, identified through a systematic review, predicting outcome in community-acquired bacterial meningitis. METHODS: MEDLINE and EMBASE were searched for articles published between January 1960 and August 2014. Performance was evaluated in 2108 episodes of adult community-acquired bacterial meningitis from two nationwide prospective cohort studies by the area under the receiver operating characteristic curve (AUC), the calibration curve, calibration slope or Hosmer-Lemeshow test, and the distribution of calculated risks. FINDINGS: Nine risk scores were identified predicting death, neurological deficit or death, or unfavorable outcome at discharge in bacterial meningitis, pneumococcal meningitis and invasive meningococcal disease. Most studies had shortcomings in design, analyses, and reporting. Evaluation showed AUCs of 0.59 (0.57-0.61) and 0.74 (0.71-0.76) in bacterial meningitis, 0.67 (0.64-0.70) in pneumococcal meningitis, and 0.81 (0.73-0.90), 0.82 (0.74-0.91), 0.84 (0.75-0.93), 0.84 (0.76-0.93), 0.85 (0.75-0.95), and 0.90 (0.83-0.98) in meningococcal meningitis. Calibration curves showed adequate agreement between predicted and observed outcomes for four scores, but statistical tests indicated poor calibration of all risk scores. INTERPRETATION: One score could be recommended for the interpretation and design of bacterial meningitis studies. None of the existing scores performed well enough to recommend routine use in individual patient management.
OBJECTIVES: To perform an external validation study of risk scores, identified through a systematic review, predicting outcome in community-acquired bacterial meningitis. METHODS: MEDLINE and EMBASE were searched for articles published between January 1960 and August 2014. Performance was evaluated in 2108 episodes of adult community-acquired bacterial meningitis from two nationwide prospective cohort studies by the area under the receiver operating characteristic curve (AUC), the calibration curve, calibration slope or Hosmer-Lemeshow test, and the distribution of calculated risks. FINDINGS: Nine risk scores were identified predicting death, neurological deficit or death, or unfavorable outcome at discharge in bacterial meningitis, pneumococcal meningitis and invasive meningococcal disease. Most studies had shortcomings in design, analyses, and reporting. Evaluation showed AUCs of 0.59 (0.57-0.61) and 0.74 (0.71-0.76) in bacterial meningitis, 0.67 (0.64-0.70) in pneumococcal meningitis, and 0.81 (0.73-0.90), 0.82 (0.74-0.91), 0.84 (0.75-0.93), 0.84 (0.76-0.93), 0.85 (0.75-0.95), and 0.90 (0.83-0.98) in meningococcal meningitis. Calibration curves showed adequate agreement between predicted and observed outcomes for four scores, but statistical tests indicated poor calibration of all risk scores. INTERPRETATION: One score could be recommended for the interpretation and design of bacterial meningitis studies. None of the existing scores performed well enough to recommend routine use in individual patient management.
Authors: Nora Chekrouni; Thijs M van Soest; Matthijs C Brouwer; Eline A J Willemse; Charlotte E Teunissen; Diederik van de Beek Journal: Neurol Neuroimmunol Neuroinflamm Date: 2021-12-13
Authors: Chris A Rees; Shubhada Hooli; Carina King; Eric D McCollum; Tim Colbourn; Norman Lufesi; Charles Mwansambo; Marzia Lazzerini; Shabir Ahmed Madhi; Clare Cutland; Marta Nunes; Bradford D Gessner; Sudha Basnet; Cissy B Kartasasmita; Joseph L Mathew; Syed Mohammad Akram Uz Zaman; Glaucia Paranhos-Baccala; Shinjini Bhatnagar; Nitya Wadhwa; Rakesh Lodha; Satinder Aneja; Mathuram Santosham; Valentina S Picot; Mariam Sylla; Shally Awasthi; Ashish Bavdekar; Jean-William Pape; Vanessa Rouzier; Monidarin Chou; Mala Rakoto-Andrianarivelo; Jianwei Wang; Pagbajabyn Nymadawa; Philippe Vanhems; Graciela Russomando; Rai Asghar; Salem Banajeh; Imran Iqbal; William MacLeod; Irene Maulen-Radovan; Greta Mino; Samir Saha; Sunit Singhi; Donald M Thea; Alexey W Clara; Harry Campbell; Harish Nair; Jennifer Falconer; Linda J Williams; Margaret Horne; Tor Strand; Shamim A Qazi; Yasir B Nisar; Mark I Neuman Journal: J Glob Health Date: 2021-10-09 Impact factor: 4.413
Authors: Diederik L H Koelman; Matthijs C Brouwer; Liora Ter Horst; Merijn W Bijlsma; Arie van der Ende; Diederik van de Beek Journal: Clin Infect Dis Date: 2022-03-01 Impact factor: 9.079