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. 2012;7(3):e34311.
doi: 10.1371/journal.pone.0034311. Epub 2012 Mar 28.

Validation of a Dutch risk score predicting poor outcome in adults with bacterial meningitis in Vietnam and Malawi

Ewout S Schut  1 , Matthijs C Brouwer, Matthew Scarborough, Nguyen Thi Hoang Mai, Guy E Thwaites, Jeremy J Farrar, Johannes B Reitsma, Diederik van de Beek
Affiliations

Validation of a Dutch risk score predicting poor outcome in adults with bacterial meningitis in Vietnam and Malawi

Ewout S Schut et al. PLoS One. 2012.

Abstract

We have previously developed and validated a prognostic model to predict the risk for unfavorable outcome in Dutch adults with bacterial meningitis. The aim of the current study was to validate this model in adults with bacterial meningitis from two developing countries, Vietnam and Malawi. Demographic and clinical characteristics of Vietnamese (n = 426), Malawian patients (n = 465) differed substantially from those of Dutch patients (n = 696). The Dutch model underestimated the risk of poor outcome in both Malawi and Vietnam. The discrimination of the original model (c-statistic [c] 0.84; 95% confidence interval 0.81 to 0.86) fell considerably when re-estimated in the Vietnam cohort (c = 0.70) or in the Malawian cohort (c = 0.68). Our validation study shows that new prognostic models have to be developed for these countries in a sufficiently large series of unselected patients.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Receiver operating characteristic curves of the final nomogram model in the Netherlands (black), Vietnam (red), and Malawi (green).
See this image and copyright information in PMC

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