Prediction tool is helping clinicians treat covid-19 patients

12 January 2021 | Muriel Cozier

Researchers suggest that the tool could also be used in other countries for risk-stratification

Researchers from the UK Coronavirus Clinical Characterisation Consortium (ISARIC4C) have developed a risk stratification online tool which can accurately predict the likelihood of deterioration in adults hospitalised with covid-19.

The tool assesses 11 measurements routinely collected from patients. It then calculates a percentage risk of deterioration, known as the ‘4C Deterioration Score.’

Publishing their work in The Lancet Respiratory Medicine, the consortium says that this latest development builds on previous work developing the ‘4C Mortality Score’ which predicts the percentage risk of death from covid-19 after being admitted to hospital.

The new tool was developed using data from 74 944 individuals with covid-19 admitted to 260 hospital across England, Scotland and Wales between 6 February and 26 August 2020. Using a multivariable logistic regression model (where several measures are used to predict an outcome) researchers tested 11 measures (age, gender, physical measures such as oxygen levels and lab tests) against the large patient cohort. This established how, and to what degree, each of the measures affected the likelihood of deterioration.

Having been assessed in nine NHS regions and performing well in each, it is likely that the tool will be useful across the NHS. The 4C Deterioration Score online tool has been made freely available to doctors in the UK’s National Health Service (NHS) and ‘could support clinicians’ decision making – helping to improve patient outcomes and ultimately save lives.’

Dr Rishi Gupta, UCL Institute of Global Health said ‘The scale and wide geographical coverage of the ISARIC4C study across the country was critical to the development of this prediction tool. Our analysis provides very encouraging evidence that the 4C Deterioration tool is likely to be useful for clinicians across England, Scotland and Wales to support clinical decision making.’

Researchers suggest that the tool could also be used in other countries for risk-stratification, but should be evaluated to test its accuracy in these settings.

DOI: 10.1016/S2213-2600(20)30559-2

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