JCI insight · 2026
Hypomorphic Lig4 gene mutation in mice predisposes to Th1-skewed intestinal inflammation.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Yamashita Yusuke, Kosako Hideki, Kato Takashi, Sasaki Izumi, Iwabuchi Sadahiro, Fukuda-Ohta Yuri, Okamura Tadashi, Tane Misato, Tabata Shotaro, Nakashima Kazutaka, Tanaka Ken, Shiraishi Kazunori, Uchihara Yuki, Okuzaki Daisuke, Isono Kyoichi, Shibata Atsushi, Mizushima Tsunehiro, Hemmi Hiroaki, Kanazawa Nobuo, Kodama Seiji, Miyoshi Hiroaki, Ohshima Koichi, Hashimoto Shinichi, Fujitani Yoshio, Sonoki Takashi, Tamura Shinobu, Kaisho Tsuneyasu
Аннотация
CONTEXT: Prognostic prediction models (PPMs) can help clinicians predict outcomes.
OBJECTIVE: To critically examine peer-reviewed PPMs predicting delayed recovery among pediatric patients with concussion.
DATA SOURCES: Ovid Medline, Embase, Ovid PsycInfo, Web of Science Core Collection, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Google Scholar.
STUDY SELECTION: The study had to report a PPM for pediatric patients to be used within 28 days of injury to estimate risk of delayed recovery at 28 days to 1 year postinjury. Studies had to have at least 30 participants.
DATA EXTRACTION: The Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modeling Studies checklist was completed.
RESULTS: Six studies of 13 PPMs were included. These studies primarily reflected male patients in late childhood or early adolescence presenting to an emergency department meeting the Concussion in Sport Group concussion criteria. No study authors used the same outcome definition nor evaluated the clinical utility of a model. All studies demonstrated high risk of bias. Quality of evidence was best for the Predicting and Preventing Postconcussive Problems in Pediatrics (5P) clinical risk score.
LIMITATIONS: No formal PPM Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) process exists.
CONCLUSIONS: The 5P clinical risk score may be considered for clinical use. Rigorous external validations, particularly in other settings, are needed. The remaining PPMs require external validation. Lack of consensus regarding delayed recovery criteria limits these PPMs.
OBJECTIVE: To critically examine peer-reviewed PPMs predicting delayed recovery among pediatric patients with concussion.
DATA SOURCES: Ovid Medline, Embase, Ovid PsycInfo, Web of Science Core Collection, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Google Scholar.
STUDY SELECTION: The study had to report a PPM for pediatric patients to be used within 28 days of injury to estimate risk of delayed recovery at 28 days to 1 year postinjury. Studies had to have at least 30 participants.
DATA EXTRACTION: The Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modeling Studies checklist was completed.
RESULTS: Six studies of 13 PPMs were included. These studies primarily reflected male patients in late childhood or early adolescence presenting to an emergency department meeting the Concussion in Sport Group concussion criteria. No study authors used the same outcome definition nor evaluated the clinical utility of a model. All studies demonstrated high risk of bias. Quality of evidence was best for the Predicting and Preventing Postconcussive Problems in Pediatrics (5P) clinical risk score.
LIMITATIONS: No formal PPM Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) process exists.
CONCLUSIONS: The 5P clinical risk score may be considered for clinical use. Rigorous external validations, particularly in other settings, are needed. The remaining PPMs require external validation. Lack of consensus regarding delayed recovery criteria limits these PPMs.