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Equine veterinary journal2022; 55(4); 573-583; doi: 10.1111/evj.13880

Clinical predictive models in equine medicine: A systematic review.

Abstract: Clinical predictive models use a patient's baseline demographic and clinical data to make predictions about patient outcomes and have the potential to aid clinical decision making. The extent of equine clinical predictive models is unknown in the literature. Using PubMed and Google Scholar, we systematically reviewed the predictive models currently described for use in equine patients. Models were eligible for inclusion if they were published in a peer-reviewed article as a multivariable model used to predict a clinical/laboratory/imaging outcome in an individual horse or herd. The agreement of at least two authors was required for model inclusion. We summarised the patient populations, model development methods, performance metric reporting, validation efforts, and, using the Predictive model Risk of Bias Assessment Tool (PROBAST), assessed the risk of bias and applicability concerns for these models. In addition, we summarised the index conditions for which models were developed and provided detailed information on included models. A total of 90 predictive models and 9 external validation studies were included in the final systematic review. A plurality of models (41%) was developed to predict outcomes associated with colic, for example, need for surgery or survival to discharge. All included models were at high risk of bias, defined as failing one or more PROBAST signalling questions, primarily for analysis-related reasons. Importantly, a high risk of bias does not necessarily mean that models are unusable, but that they require more careful consideration prior to clinical use. Concerns about applicability were low for the majority of models. Systematic reviews such as this can serve to increase veterinarians' awareness of predictive models, including evaluation of their performance and their use in different patient populations.
Publication Date: 2022-11-08 PubMed ID: 36199162PubMed Central: PMC10073351DOI: 10.1111/evj.13880Google Scholar: Lookup
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  • Systematic Review
  • Journal Article
  • Review

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research study conducted a systematic review of clinical predictive models in equine medicine, assessing their risk of bias, validation efforts, and usefulness in predicting patient outcomes.

Research Methodology

  • The researchers conducted a systematic review of clinical predictive models for horses by searching through scholarly articles on PubMed and Google Scholar.
  • The criteria for inclusion necessitated that the models must have been published in a peer-reviewed article, and they must predict clinical, laboratory, or imaging outcomes for either individual horses or entire herds.
  • The agreement of at least two authors was required for a model to be included in the review.

Analysis Tools and Data Considerations

  • The researchers analyzed the models using the Predictive model Risk of Bias Assessment Tool (PROBAST) to evaluate the risk of bias and concerns about applicability.
  • The metrics that the researchers used to judge the performance of these models were also examined.
  • Models with a “high risk of bias” were those that failed one or more PROBAST signalling questions, primarily for reasons related to analysis.

Findings from the Systematic Review

  • A total of 90 predictive models and 9 external validation studies were included in the review.
  • Of these, most (41%) were developed to predict outcomes associated with colic, such as the necessity for surgery or whether the horse would survive to discharge.
  • All of the models in the systematic review were identified as having a high risk of bias. However, this does not automatically mean the models are unusable, but it does point to the need for more careful evaluation before being relied upon in a clinical setting.
  • The majority of models introduced low concern over applicability, indicating that they could be widely useful.

Significance of Study

  • This systematic review can increase awareness among veterinarians about these predictive models, their performance, and their potential applications in different patient populations.
  • By highlighting potential biases, the study also promotes the need for careful consideration and validation of these models before they are used in clinical decision making.

Cite This Article

APA
Cummings CO, Krucik DDR, Price E. (2022). Clinical predictive models in equine medicine: A systematic review. Equine Vet J, 55(4), 573-583. https://doi.org/10.1111/evj.13880

Publication

ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 55
Issue: 4
Pages: 573-583

Researcher Affiliations

Cummings, Charles O
  • Tufts Clinical and Translational Science Institute, Tufts Medical Center, Boston, Massachusetts, USA.
Krucik, David D R
  • Department of Comparative Medicine, Stanford University, California, USA.
Price, Emma
  • Tufts Clinical and Translational Science Institute, Tufts Medical Center, Boston, Massachusetts, USA.

MeSH Terms

  • Horses
  • Animals
  • Prognosis
  • Bias

Grant Funding

  • TL1 TR002546 / NCATS NIH HHS
  • T32OD011121 / NIH HHS
  • TL1TR002546 / NCATS NIH HHS
  • TL1TR002546 / NCATS NIH HHS
  • T32OD011121 / NIH HHS

Conflict of Interest Statement

Competing Interests. No competing interests have been declared.

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