BACKGROUND: Clinical prediction rules are decision-making tools for clinicians, containing variables from the history, physical examination, or simple diagnostic tests. OBJECTIVE: To review the quality of recently published clinical prediction rules and to suggest methodological standards for their development and evaluation. DATA SOURCES: Four general medical journals were manually searched for clinical prediction rules published from 1991 through 1994. STUDY SELECTION: Four hundred sixty potentially eligible reports were identified, of which 30 were clinical prediction rules eligible for study. Most methodological standards could only be evaluated in 29 studies. DATA ABSTRACTION: Two investigators independently evaluated the quality of each report using a standard data sheet. Disagreements were resolved by consensus. DATA SYNTHESIS: The mathematical technique was used to develop the rule, and the results of the rule were described in 100% (29/29) of the reports. All the rules but 1 (97% [28/29]) were felt to be clinically sensible. The outcomes and predictive variables were clearly defined in 83% (24/29) and 59% (17/29) of the reports, respectively. Blind assessment of outcomes and predictive variables occurred in 41% (12/29) and 79% (23/29) of the reports, respectively, and the rules were prospectively validated in 79% (11/14). Reproducibility of predictive variables was assessed in only 3% (1/29) of the reports, and the effect of the rule on clinical use was prospectively measured in only 3% (1/30). Forty-one percent (12/29) of the rules were felt to be easy to use. CONCLUSIONS: Although clinical prediction rules comply with some methodological criteria, for other criteria, better compliance is needed.
BACKGROUND: Clinical prediction rules are decision-making tools for clinicians, containing variables from the history, physical examination, or simple diagnostic tests. OBJECTIVE: To review the quality of recently published clinical prediction rules and to suggest methodological standards for their development and evaluation. DATA SOURCES: Four general medical journals were manually searched for clinical prediction rules published from 1991 through 1994. STUDY SELECTION: Four hundred sixty potentially eligible reports were identified, of which 30 were clinical prediction rules eligible for study. Most methodological standards could only be evaluated in 29 studies. DATA ABSTRACTION: Two investigators independently evaluated the quality of each report using a standard data sheet. Disagreements were resolved by consensus. DATA SYNTHESIS: The mathematical technique was used to develop the rule, and the results of the rule were described in 100% (29/29) of the reports. All the rules but 1 (97% [28/29]) were felt to be clinically sensible. The outcomes and predictive variables were clearly defined in 83% (24/29) and 59% (17/29) of the reports, respectively. Blind assessment of outcomes and predictive variables occurred in 41% (12/29) and 79% (23/29) of the reports, respectively, and the rules were prospectively validated in 79% (11/14). Reproducibility of predictive variables was assessed in only 3% (1/29) of the reports, and the effect of the rule on clinical use was prospectively measured in only 3% (1/30). Forty-one percent (12/29) of the rules were felt to be easy to use. CONCLUSIONS: Although clinical prediction rules comply with some methodological criteria, for other criteria, better compliance is needed.
Authors: Erik P Hess; Dipti Agarwal; Subhash Chandra; Mohammed H Murad; Patricia J Erwin; Judd E Hollander; Victor M Montori; Ian G Stiell Journal: CMAJ Date: 2010-06-07 Impact factor: 8.262
Authors: Paul K J Han; Minjung Lee; Bryce B Reeve; Angela B Mariotto; Zhuoqiao Wang; Ron D Hays; K Robin Yabroff; Marie Topor; Eric J Feuer Journal: J Pain Symptom Manage Date: 2011-11-08 Impact factor: 3.612
Authors: Nl de Groot; Mgh van Oijen; K Kessels; M Hemmink; Blam Weusten; R Timmer; Wl Hazen; N van Lelyveld; Wl Curvers; Lc Baak; R Verburg; Jh Bosman; Lrh de Wijkerslooth; J de Rooij; Ng Venneman; M Pennings; K van Hee; Rch Scheffer; Rl van Eijk; R Meiland; Pd Siersema; Aj Bredenoord Journal: United European Gastroenterol J Date: 2014-06 Impact factor: 4.623