Imperial College London
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DrRyanThwaites

Faculty of Medicine, National Heart & Lung Institute

Lecturer in Respiratory Immunology
 
 
 
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r.thwaites

 
 
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Respiratory InfectionsMedical SchoolSt Mary's Campus

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Summary

 

Publications

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BibTex format

@article{Gupta:2021:10.1016/S2213-2600(20)30559-2,
author = {Gupta, RK and Harrison, EM and Ho, A and Docherty, AB and Knight, SR and van, Smeden M and Abubakar, I and Lipman, M and Quartagno, M and Pius, R and Buchan, I and Carson, G and Drake, TM and Dunning, J and Fairfield, CJ and Gamble, C and Green, CA and Halpin, S and Hardwick, HE and Holden, KA and Horby, PW and Jackson, C and Mclean, KA and Merson, L and Nguyen-Van-Tam, JS and Norman, L and Olliaro, PL and Pritchard, MG and Russell, CD and Scott-Brown, J and Shaw, CA and Sheikh, A and Solomon, T and Sudlow, C and Swann, OV and Turtle, L and Openshaw, PJM and Baillie, JK and Semple, MG and Noursadeghi, M and Baillie, JK and Semple, MG and Openshaw, PJM and Carson, G and Alex, B and Bach, B and Barclay, WS and Bogaert, D and Chand, M and Cooke, GS and Docherty, AB and Dunning, J and Filipe, ADS and Fletcher, T and Green, CA and Harrison, EM and Hiscox, JA and Ho, AYW and Horby, PW and Ijaz, S and Khoo, S and Klenerman, P and Law, A and Lim, WS and Mentzer, AJ and Merson, L and Meynert, A},
doi = {10.1016/S2213-2600(20)30559-2},
journal = {The Lancet Respiratory Medicine},
pages = {349--359},
title = {Development and validation of the ISARIC 4C Deterioration model for adults hospitalised with COVID-19: a prospective cohort study},
url = {http://dx.doi.org/10.1016/S2213-2600(20)30559-2},
volume = {9},
year = {2021}
}
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TY  - JOUR
AB  - BackgroundPrognostic models to predict the risk of clinical deterioration in acute COVID-19 cases are urgently required to inform clinical management decisions.MethodsWe developed and validated a multivariable logistic regression model for in-hospital clinical deterioration (defined as any requirement of ventilatory support or critical care, or death) among consecutively hospitalised adults with highly suspected or confirmed COVID-19 who were prospectively recruited to the International Severe Acute Respiratory and Emerging Infections Consortium Coronavirus Clinical Characterisation Consortium (ISARIC4C) study across 260 hospitals in England, Scotland, and Wales. Candidate predictors that were specified a priori were considered for inclusion in the model on the basis of previous prognostic scores and emerging literature describing routinely measured biomarkers associated with COVID-19 prognosis. We used internal–external cross-validation to evaluate discrimination, calibration, and clinical utility across eight National Health Service (NHS) regions in the development cohort. We further validated the final model in held-out data from an additional NHS region (London).Findings74944 participants (recruited between Feb 6 and Aug 26, 2020) were included, of whom 31924 (43·2%) of 73948 with available outcomes met the composite clinical deterioration outcome. In internal–external cross-validation in the development cohort of 66705 participants, the selected model (comprising 11 predictors routinely measured at the point of hospital admission) showed consistent discrimination, calibration, and clinical utility across all eight NHS regions. In held-out data from London (n=8239), the model showed a similarly consistent performance (C-statistic 0·77 [95% CI 0·76 to 0·78]; calibration-in-the-large 0·00 [–0·05 to 0·05]); calibration slope 0·96 [0·91 to 1·01]), and greater net benefit than
AU  - Gupta,RK
AU  - Harrison,EM
AU  - Ho,A
AU  - Docherty,AB
AU  - Knight,SR
AU  - van,Smeden M
AU  - Abubakar,I
AU  - Lipman,M
AU  - Quartagno,M
AU  - Pius,R
AU  - Buchan,I
AU  - Carson,G
AU  - Drake,TM
AU  - Dunning,J
AU  - Fairfield,CJ
AU  - Gamble,C
AU  - Green,CA
AU  - Halpin,S
AU  - Hardwick,HE
AU  - Holden,KA
AU  - Horby,PW
AU  - Jackson,C
AU  - Mclean,KA
AU  - Merson,L
AU  - Nguyen-Van-Tam,JS
AU  - Norman,L
AU  - Olliaro,PL
AU  - Pritchard,MG
AU  - Russell,CD
AU  - Scott-Brown,J
AU  - Shaw,CA
AU  - Sheikh,A
AU  - Solomon,T
AU  - Sudlow,C
AU  - Swann,OV
AU  - Turtle,L
AU  - Openshaw,PJM
AU  - Baillie,JK
AU  - Semple,MG
AU  - Noursadeghi,M
AU  - Baillie,JK
AU  - Semple,MG
AU  - Openshaw,PJM
AU  - Carson,G
AU  - Alex,B
AU  - Bach,B
AU  - Barclay,WS
AU  - Bogaert,D
AU  - Chand,M
AU  - Cooke,GS
AU  - Docherty,AB
AU  - Dunning,J
AU  - Filipe,ADS
AU  - Fletcher,T
AU  - Green,CA
AU  - Harrison,EM
AU  - Hiscox,JA
AU  - Ho,AYW
AU  - Horby,PW
AU  - Ijaz,S
AU  - Khoo,S
AU  - Klenerman,P
AU  - Law,A
AU  - Lim,WS
AU  - Mentzer,AJ
AU  - Merson,L
AU  - Meynert,AM
AU  - Noursadeghi,M
AU  - Moore,SC
AU  - Palmarini,M
AU  - Paxton,WA
AU  - Pollakis,G
AU  - Price,N
AU  - Rambaut,A
AU  - Robertson,DL
AU  - Russell,CD
AU  - Sancho-Shimizu,V
AU  - Scott,JT
AU  - de,Silva T
AU  - Sigfrid,L
AU  - Solomon,T
AU  - Sriskandan,S
AU  - Stuart,D
AU  - Summers,C
AU  - Tedder,RS
AU  - Thomson,EC
AU  - Thompson,AAR
AU  - Thwaites,RS
AU  - Turtle,LCW
AU  - Zambon,M
AU  - Hardwick,H
AU  - Donohue,C
AU  - Lyons,R
AU  - Griffiths,F
AU  - Oosthuyzen,W
AU  - Norman,L
AU  - Pius,R
AU  - Drake,TM
AU  - Fairfield,CJ
AU  - Knight,S
AU  - Mclean,KA
AU  - Murphy,D
AU  - Shaw,CA
AU  - Dalton,J
AU  - Lee,J
AU  - Plotkin,D
AU  - Girvan,M
AU  - Mullaney,S
AU  - Petersen,C
AU  - Saviciute,E
AU  - Roberts,S
AU  - Harrison,J
AU  - Marsh,L
AU  - Connor,M
AU  - Halpin,S
AU  - Jackson,C
AU  - Gamble,C
AU  - Leeming,G
AU  - Law,A
AU  - Wham,M
AU  - Clohisey,S
AU  - Hendry,R
AU  - Scott-Brown,J
AU  - Greenhalf,W
AU  - Shaw,V
AU  - McDonald,S
AU  - Keating,S
AU  - Ahmed,KA
AU  - Armstrong,JA
AU  - Ashworth,M
AU  - Asiimwe,IG
AU  - Bakshi,S
AU  - Barlow,SL
AU  - Booth,L
AU  - Brennan,B
AU  - Bullock,K
AU  - Catterall,BWA
AU  - Clark,JJ
AU  - Clarke,EA
AU  - Cole,S
AU  - Cooper,L
AU  - Cox,H
AU  - Davis,C
AU  - Dincarslan,O
AU  - Dunn,C
AU  - Dyer,P
AU  - Elliott,A
AU  - Evans,A
AU  - Finch,L
AU  - Fisher,LWS
AU  - Foster,T
AU  - Garcia-Dorival,I
AU  - Greenhalf,W
AU  - Gunning,P
AU  - Hartley,C
AU  - Ho,A
AU  - Jensen,RL
AU  - Jones,CB
AU  - Jones,TR
AU  - Khandaker,S
AU  - King,K
AU  - Kiy,RT
AU  - Koukorava,C
AU  - Lake,A
AU  - Lant,S
AU  - Latawiec,D
AU  - Lavelle-Langham,L
AU  - Lefteri,D
AU  - Lett,L
AU  - Livoti,LA
AU  - Mancini,M
AU  - McDonald,S
AU  - McEvoy,L
AU  - McLauchlan,J
AU  - Metelmann,S
AU  - Miah,NS
AU  - Middleton,J
AU  - Mitchell,J
AU  - Moore,SC
AU  - Murphy,EG
AU  - Penrice-Randal
DO  - 10.1016/S2213-2600(20)30559-2
EP  - 359
PY  - 2021///
SN  - 2213-2600
SP  - 349
TI  - Development and validation of the ISARIC 4C Deterioration model for adults hospitalised with COVID-19: a prospective cohort study
T2  - The Lancet Respiratory Medicine
UR  - http://dx.doi.org/10.1016/S2213-2600(20)30559-2
UR  - https://doi.org/10.1016/S2213-2600(20)30559-2
UR  - https://www.sciencedirect.com/science/article/pii/S2213260020305592
UR  - http://hdl.handle.net/10044/1/85694
VL  - 9
ER  -
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