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Table 4 Characteristics of model validation studies

From: Prognostic models for outcome prediction following in-hospital cardiac arrest using pre-arrest factors: a systematic review, meta-analysis and critical appraisal

Reference (year of publication)

Model validated

Study population (cohort type, included patients)

No. of participants (no. with predicted outcome)

Study interval

Source of data

Country of inclusion (no. of centres)

Predicted outcome

Method of validation

Evaluation of model performance

Calibration

Discrimination

Classification

Cho et al. [39]

GO-FAR

Attempted CPR for IHCA

1011 (162)

2013–2017

Retrospective cohort

South Korea (1)

Survival to discharge with CPC 1 or 2

Fully independent validation

n.r.

AUC: 0.81(CI 0.78–0.84)

Best at 4 for poor outcome: sensitivity 72.5% (CI 69.5–75-5), specificity 78.6% (CI 70.4–85.4), PPV 96.0% (CI 94.4–97.1), NPV 29.0% (CI 26.1–31.9)

Thai et al. [40]

GO-FAR

Attempted CPR for IHCA

62.131 (9347)

2010–2016

GWTG Registry

USA (386)

Survival to discharge with CPC = 1

External validation; authors include initial author of score

Calibration plot (score systematically underestimates the likelihood of survival with CPC 1)

AUC: 0.75 (CI 0.748–0.758)

Classification table

Rubins et al. [41]

GO-FAR

Attempted CPR for IHCA

403 (133, 70)

2009–2018

Retrospective cohort

USA (1)

Survival to discharge and survival to discharge with CPC = 1

Fully independent validation

n.r.

For survival to discharge with CPC = 1: AUC = 0.68(CI 0.62–0.73)

n.r.

Piscator et al. [42]

GO-FAR

Attempted CPR for IHCA

528 (141) (complete cases)

2013–2014

SCR Registry

Sweden (6)

Survival to discharge with CPC = 1

External validation; authors include initial author of score

Calibration plot (GO-FAR model under-predicts the probability of survival with CPC = 1)

Complete cases: AUC = 0.82(CI 0.78–0.86) (AUC = 0.80 (CI 0.76–0.84) for multiple imputation analysis)

Classification table

Limpawattama et al. [50]

PAM, PAR, MPI

Attempted CPR for IHCA

278 (72) (166 complete IHCA cases)

2013–2014

Retrospective cohort

Thailand (1)

Survival to discharge

Fully independent validation

n.r.

AUC: PAM = 0.62(CI 0.51–0.73), PAR = 0.60(CI 0.49–0.71), MPI = 0.63(CI 0.52–0.73)

n.r. for only IHCA

Guilbault et al. [43]

CART1, CART2

Attempted CPR for IHCA

287 (45)

2007–2010

Retrospective cohort

Sweden (1)

Survival to discharge with CPC = 1

External validation; authors include initial author of score

n.r.

CART 1: AUC = 0.77. CART 2: AUC = 0.71

Classification table

Ohlsson et al. [44]

GO-FAR

Attempted CPR for IHCA

287 (45)

2007–2010

Retrospective cohort

Sweden (1)

Survival to discharge with CPC = 1

External validation; authors include initial author of score

n.r.

AUC: 0.85 (CI 0.78–0.91)

Best sensitivity and specificity at -3.5: 79% and 78%

Ohlsson et al. [45]

PAM, PAR

Attempted CPR for IHCA

287 (58)

2007–2010

Retrospective cohort

Sweden (1)

Survival to discharge

Fully independent validation

n.r.

AUC: PAM = 0.601(CI 0.528–0.674 p = 0.018), PAR = 0.718(CI 0.647–0.79 p =  < 0.001)

Sensitivity, specificity: PAM > 5 = 21.8%, 94.8%. PAR > 5 = 31%, 94.8%

Bowker et al. [46]

PAM, PAR, MPI

Attempted CPR for IHCA

264 (28)

1994–1996

Retrospective cohort

UK (1)

Survival to discharge

Fully independent validation

n.r.

n.r

Sensitivity: PAM > 6 = 20%, PAR > 7 = 29%, MPI > 6 = 22% (specificity for all 100%)

Ebell et al. [51]

PAM, PAR, APACHE III

Attempted CPR for IHCA

656 (248, 35)

2–3 years (not further specified)

Retrospective cohort

USA (3)

ROSC with transfer to ICU & survival to discharge

External validation; authors include initial author of score

n.r.

AUC: ROSC: PAR = 0.51(SE = 0.023), PAM = 0.495(SE = 0.023), APACHE III 0.495(SE = 0.023). Survival to discharge: PAR = 0.564(SE = 0.05), PAM = 0.519(SE = 0.051), APACHE III = 0.587(SE = 0.049)

n.r.

O'keeffe et al. [48]

PAM, PAR

Attempted CPR for IHCA

274 (25)

2 years (not further specified)

Retrospective cohort

Ireland (1)

Survival to discharge

External validation; authors include initial author of score

n.r.

AUC: PAM = 0.67 (SE = 0.06) PAR = 0.74 (0.05)

Sensitivity: PAM > 4 = 9.2%, > 8 = 2%. PAR: > 5 = 23.7%, > 8 = 9.6%. Specificity: 100% for both scores at all cut-off points

Cohn et al. [49]

PAM (minus S3 gallop)

Survivors of attempted CPR for IHCA and matched non-survivors

86 (43)

1986–1991

Retrospective case–control

USA (1)

Survival to discharge

Fully independent validation

n.r.

p < 0.0003; R2 = 9.6%

n.r.