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Prognostic models and risk scores: can we accurately predict postoperative nausea and vomiting in children after
Susan M Neufeld1, Christine V Newburn-Cook, Jane E Drummond
1Canadian Child Health Clinician Scientist Program, Faculty of Nursing, University of Alberta, Edmonton, AB, Canada. smn@ualberta.ca.
Insights
Existing risk scores do not accurately predict postoperative nausea and vomiting (PONV) in children after craniotomy. Further research is needed to develop reliable tools for predicting PONV in this patient group.
Area of Science:
- Pediatric Anesthesiology
- Surgical Outcomes Research
Background:
- Postoperative nausea and vomiting (PONV) is a common complication in pediatric patients following craniotomy.
- Accurate prediction of PONV is crucial for guiding clinical management and preventing adverse events.
Purpose of the Study:
- To evaluate the efficacy of existing prognostic models and risk scores in predicting PONV in children undergoing craniotomy.
- To identify the criteria for a valid clinical prediction tool, including transportability, calibration, and discrimination.
Main Methods:
- Systematic review and critical appraisal of existing prognostic models and risk scores.
- Assessment of model performance based on established criteria for clinical utility.
Main Results:
- Current prognostic models and risk scores are not suitable for predicting PONV in pediatric craniotomy patients.
- Existing tools lack the necessary transportability, calibration, and discrimination for this specific population.
Conclusions:
- Existing prognostic models and risk scores are inadequate for predicting PONV in children after craniotomy.
- Further research is required to identify specific risk factors and develop validated prediction tools for this population.
- Clinical judgment, informed by current research, remains essential for managing PONV in pediatric craniotomy patients.
Abstract:
Postoperative nausea and vomiting (PONV) is a problem for many children after craniotomy. Prognostic models and risk scores help identify who is at risk for an adverse event such as PONV to help guide clinical care. The purpose of this article is to assess whether an existing prognostic model or risk score can predict PONV in children after craniotomy. The concepts of transportability, calibration, and discrimination are presented to identify what is required to have a valid tool for clinical use. Although previous work may inform clinical practice and guide future research, existing prognostic models and risk scores do not appear to be options for predicting PONV in children undergoing craniotomy. However, until risk factors are further delineated, followed by the development and validation of prognostic models and risk scores that include children after craniotomy, clinical judgment in the context of current research may serve as a guide for clinical care in this population.
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