Comparing In-Hospital Mortality Prediction by Senior Emergency Resident’s Judgment and Prognostic Models in the Emergency Department

Table 4

Published studies comparing the performance of models with physician clinical judgment.

Study	Year	Country	Sample size (N)	Male gender (%)	Age^a; or median (IQR)	Outcome rate (%)	Setting	Diagnosis	Prognostic model	Outcome events	AUROC; Model versus physician prognoses
[37]	1988	US	366	NA	NA	40%	ICU	Case-mix	APACHE II	Hospital mortality	0.89 vs. 0.89
[1]	1989	US	523	44%		25%	ICU + Ward	Case-mix	APACHE II	Hospital mortality	0.83 vs. 0.89
[20]	1989	US	215	43%	: deceased; : survivors	30.2%	ICU	Case-mix	APACHE II	Hospital mortality	80 vs. 90
[38]	2010	US	137	NA	Neonate <4 weeks	34%	ICU	Candidiasis	Neonatal candidiasis	Hospital mortality	0.79 vs. 0.70
[13]	2019	US	1874	50%	56 (42–70)	1.9%	Internal medicine wards	Case-mix	EWS	Clinical deteriorations in 24 hours	0.73 vs. 0.70
[39]	2013	Netherlands	323	57%		22%	ED	Sepsis	PIRO	28-day mortality	0.68 vs. 0.69 in high-risk; 0.83 vs. 0.84 in low-risk
[40]	2017	Netherlands	193	56%	60 (48–71)	4.1%	ED	Sepsis	qSOFA PIRO	Hospital mortality	0.849 vs. 0.861; 0.876 vs. 0.861
[23]	2020	US	405	60%		8.2%	ED	Sepsis	qSOFA	28-day mortality	0.63 vs. 0.80
[10]	2019	US	314	57%	61.7 (17.1): deceased; 55.6 (16.8): survivors	9.9%	ED	SIRS+	Biomarker	28-day mortality	0.72 vs. 0.78
[13]	2019	US	1874	51%	56 (42–70)	1.9%	Ward	Case-mix	EWS	24 h clinical deterioration	0.73 vs. 0.70
[21]	2004	Germany	412	59%		17.7%	ICU	Case-mix	SAPS II	Hospital mortality	0.75 vs. 0.84
[22]	2001	US	235	54%		18.85%	ICU	Non-trauma	MPM	24 h ICU mortality	NA
[24]	2018	Spain	154	37%		8.4%	ED	Pulmonary embolism	PESI; sPESI	30-day mortality	0.73 vs. 0.65; 0.77 vs. 0.65
[25]	2018	China	220	62.73%		13.6%	ED	Shock	LiPS	30-day mortality	0.72 vs. 0.62
[34]	2021	Sweden	323	58.5%	78 (72–85)	44.6%	ED	Sepsis	NEWS2, RETTS	Sepsis within 36 h from ED arrival	0.67 vs. 0.57; 0.68 vs. 0.57
[41]	2021	UK	1,344	42%	70.8 (58.4-82.8)	13.0%	ED	Sepsis	Machine learning; SOFA; mREMS	31-day mortality	0.85 vs. 0.73; 0.75 vs. 0.73; 0.64 vs. 0.73
Current study	2020	Iran	2,205	53%		19%	ED	Case-mix	mSOFA; qSOFA	Hospital mortality	0.74 vs. 0.68; 0.70 vs. 0.68

Abbreviation: APACHE II: Acute Physiology and Chronic Health Evaluation; qSOFA: quick Sepsis-Related Organ Failure Assessment; EWS: early warning score; SAPS: Simplified Acute Physiology Score; MPM: Mortality Prediction Model; PIRO: the predisposition, infection, response, and organ failure; PESI: Pulmonary Embolism Severity Index; sPESI: Simplified Pulmonary Embolism Severity Index; LiPS: Li’s pragmatic shock; mSOFA: modified Sepsis-Related Organ Failure Assessment.