Systematic review of predictive performance of injury severity scoring tools

<p>Abstract</p> <p>Many injury severity scoring tools have been developed over the past few decades. These tools include the Injury Severity Score (ISS), New ISS (NISS), Trauma and Injury Severity Score (TRISS) and International Classification of Diseases (ICD)-based Injury Severit...

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Main Authors: Tohira Hideo, Jacobs Ian, Mountain David, Gibson Nick, Yeo Allen
Format: Article
Language:English
Published: BMC 2012-09-01
Series:Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Subjects:
Online Access:http://www.sjtrem.com/content/20/1/63
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author Tohira Hideo
Jacobs Ian
Mountain David
Gibson Nick
Yeo Allen
author_facet Tohira Hideo
Jacobs Ian
Mountain David
Gibson Nick
Yeo Allen
author_sort Tohira Hideo
collection DOAJ
description <p>Abstract</p> <p>Many injury severity scoring tools have been developed over the past few decades. These tools include the Injury Severity Score (ISS), New ISS (NISS), Trauma and Injury Severity Score (TRISS) and International Classification of Diseases (ICD)-based Injury Severity Score (ICISS). Although many studies have endeavored to determine the ability of these tools to predict the mortality of injured patients, their results have been inconsistent. We conducted a systematic review to summarize the predictive performances of these tools and explore the heterogeneity among studies. We defined a relevant article as any research article that reported the area under the Receiver Operating Characteristic curve as a measure of predictive performance. We conducted an online search using MEDLINE and Embase. We evaluated the quality of each relevant article using a quality assessment questionnaire consisting of 10 questions. The total number of positive answers was reported as the quality score of the study. Meta-analysis was not performed due to the heterogeneity among studies. We identified 64 relevant articles with 157 AUROCs of the tools. The median number of positive answers to the questionnaire was 5, ranging from 2 to 8. Less than half of the relevant studies reported the version of the Abbreviated Injury Scale (AIS) and/or ICD (37.5%). The heterogeneity among the studies could be observed in a broad distribution of crude mortality rates of study data, ranging from 1% to 38%. The NISS was mostly reported to perform better than the ISS when predicting the mortality of blunt trauma patients. The relative performance of the ICSS against the AIS-based tools was inconclusive because of the scarcity of studies. The performance of the ICISS appeared to be unstable because the performance could be altered by the type of formula and survival risk ratios used. In conclusion, high-quality studies were limited. The NISS might perform better in the mortality prediction of blunt injuries than the ISS. Additional studies are required to standardize the derivation of the ICISS and determine the relative performance of the ICISS against the AIS-based tools.</p>
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spelling doaj.art-317890eba5d14a5b9e255dd9959590e82022-12-21T21:04:52ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412012-09-012016310.1186/1757-7241-20-63Systematic review of predictive performance of injury severity scoring toolsTohira HideoJacobs IanMountain DavidGibson NickYeo Allen<p>Abstract</p> <p>Many injury severity scoring tools have been developed over the past few decades. These tools include the Injury Severity Score (ISS), New ISS (NISS), Trauma and Injury Severity Score (TRISS) and International Classification of Diseases (ICD)-based Injury Severity Score (ICISS). Although many studies have endeavored to determine the ability of these tools to predict the mortality of injured patients, their results have been inconsistent. We conducted a systematic review to summarize the predictive performances of these tools and explore the heterogeneity among studies. We defined a relevant article as any research article that reported the area under the Receiver Operating Characteristic curve as a measure of predictive performance. We conducted an online search using MEDLINE and Embase. We evaluated the quality of each relevant article using a quality assessment questionnaire consisting of 10 questions. The total number of positive answers was reported as the quality score of the study. Meta-analysis was not performed due to the heterogeneity among studies. We identified 64 relevant articles with 157 AUROCs of the tools. The median number of positive answers to the questionnaire was 5, ranging from 2 to 8. Less than half of the relevant studies reported the version of the Abbreviated Injury Scale (AIS) and/or ICD (37.5%). The heterogeneity among the studies could be observed in a broad distribution of crude mortality rates of study data, ranging from 1% to 38%. The NISS was mostly reported to perform better than the ISS when predicting the mortality of blunt trauma patients. The relative performance of the ICSS against the AIS-based tools was inconclusive because of the scarcity of studies. The performance of the ICISS appeared to be unstable because the performance could be altered by the type of formula and survival risk ratios used. In conclusion, high-quality studies were limited. The NISS might perform better in the mortality prediction of blunt injuries than the ISS. Additional studies are required to standardize the derivation of the ICISS and determine the relative performance of the ICISS against the AIS-based tools.</p>http://www.sjtrem.com/content/20/1/63ISSNISSTRISSICISSAUROCOutcome prediction
spellingShingle Tohira Hideo
Jacobs Ian
Mountain David
Gibson Nick
Yeo Allen
Systematic review of predictive performance of injury severity scoring tools
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
ISS
NISS
TRISS
ICISS
AUROC
Outcome prediction
title Systematic review of predictive performance of injury severity scoring tools
title_full Systematic review of predictive performance of injury severity scoring tools
title_fullStr Systematic review of predictive performance of injury severity scoring tools
title_full_unstemmed Systematic review of predictive performance of injury severity scoring tools
title_short Systematic review of predictive performance of injury severity scoring tools
title_sort systematic review of predictive performance of injury severity scoring tools
topic ISS
NISS
TRISS
ICISS
AUROC
Outcome prediction
url http://www.sjtrem.com/content/20/1/63
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