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Table 3 Comparisons of prognostic accuracy and reclassification improvement based on tested scores

From: Derivation and validation of an easy-to-compute trauma score that improves prognostication of mortality or the Trauma Rating Index in Age, Glasgow Coma Scale, Respiratory rate and Systolic blood pressure (TRIAGES) score

Analyses

Metrics of score performance

Bootstrap comparisons

TRIAGES score

RTS

MGAP score

TRIAGES score versus RTS

TRIAGES score versus MGAP score

Difference [95%CI]

P

Difference [95%CI]

P

Primary analysis

 Area under curve

  JTDB validation cohort (n = 76,762)

0.932

0.907

0.918

0.025 [0.023, 0.028]

< 0.001

0.014 [0.012, 0.016]

< 0.001

  CRASH-2 cohort (n = 19,740)

0.814

0.808

0.774

0.006 [0.001, 0.011]

0.010

0.040 [0.033, 0.047]

< 0.001

 Sensitivity analyses for the primary analysis

  Area under curve

       

  Multiple imputation

       

  JTDB validation cohort (n = 110,884)

0.917

0.894

0.902

0.023 [0.020, 0.025]

< 0.001

0.015 [0.013, 0.017]

< 0.001

  CRASH-2 cohort (n = 20,197)

0.816

0.810

0.776

0.006 [0.002, 0.011]

0.006

0.040 [0.034, 0.046]

< 0.001

 Single imputation by the best value

  JTDB validation cohort (n = 97,248)

0.911

0.889

0.899

0.022 [0.019, 0.024]

< 0.001

0.012 [0.009, 0.014]

< 0.001

  CRASH-2 cohort (n = 20,197)

0.813

0.806

0.776

0.006 [0.002, 0.011]

0.006

0.037 [0.031, 0.043]

< 0.001

 Prehospital variables

  JTDB validation cohort (n = 110,885)

0.858

0.786

0.833

0.072 [0.066, 0.078]

< 0.001

0.025 [0.021, 0.030]

< 0.001

Secondary analyses

 Partial area under curve (sensitivity ≥ 0.9)

  JTDB validation cohort (n = 110,885)

0.764

0.652

0.722

0.112 [0.102, 0.121]

< 0.001

0.042 [0.033, 0.050]

< 0.001

  CRASH-2 cohort (n = 20,197)

0.629

0.592

0.560

0.037 [0.026, 0.048]

< 0.001

0.069 [0.057, 0.081]

< 0.001

 Net reclassification improvement

  JTDB validation cohort (n = 110,885)

   

0.465 [0.441, 0.489]

< 0.001

0.422 [0.396, 0.447]

< 0.001

  CRASH-2 cohort (n = 20,197)

   

0.230 [0.177, 0.312]

0.004

0.239 [0.176, 0.318]

< 0.001

  1. Point estimation with 95%CI and P values of the metrics of score performance were computed by bootstrap estimation repeated 20,000 times (800 times per each dataset if bootstrapping was performed on multiply imputed datasets)
  2. TRIAGES Trauma Rating Index in Age, Glasgow Coma Scale, Respiratory rate and Systolic blood pressure; RTS Revised Trauma Score; MGAP Mechanism, Glasgow Coma Scale, Age, and Arterial Pressure; 95%CI 95% confidence interval; JTDB Japan Trauma Databank; CRASH-2 Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage-2