Diagnoctic test accuracy of nucleated red blood cells in non-hematologic intensive care patients (meta-analysis)
Bibliographic record
Abstract
Background. Nucleated red blood cells (NRBC) are reticulocyte precursors detected in the complete blood cell count and absent in the bloodstream of a healthy adult. The presence of NRBC in adult non-hematologic patients is being studied as a biomarker of an unfavorable outcome. Objective. To determine the NRBC-positive patients’ prevalence in the non-hematologic intensive care unit (ICU) and assess NRBC diagnostic accuracy as a predictor of mortality. Material and methods. A meta-analysis that included 19 studies with 5785 severe and critically ill patients was performed: 16 articles contained qualitative data of NRBC and 5 studies had data of NRBC quantitative assays. The literature search was conducted in the following databases — PubMed, Researcher Gate and e-library. Risk of bias in non-randomized studies was assessed using the Russian-language version of the Newcastle Ottawa Scale, studies included in meta-analysis of diagnostic test accuracy additionally was evaluated using the Russian-language version of the QUADAS Questionnaire. Results. The pooled prevalence of NRBC-positive non-hematologic ICU patients was 36.6%. The overall mortality of NRBC-positive patients was 49.0%. The weighted mean difference of NRBC values between survivors and non-survivors was –520.43 μl–1, for patients with ARDS: –1093.11 μl–1, and without ARDS: –282.87 μl–1. A meta-analysis of studies with univariate analysis showed that the pooled risk ratio (RR) of intrahospital all-cause mortality increased 4.28-fold (95% CI 2.63—6.94, p<0.00001, I2=96%, p<0.00001) in NRBC-positive patients, in studies with multivariate analysis (Cox Regression) the pooled hazard ratio (HR) of all-cause mortality was 1.26 (CI 95% 1.00—1.59, p=0.05, I2=65%, p=0.04). Hierarchical summary receiver operating characteristic analysis showed areas under the curves 0.745, pooled sensitivity and specificity were 72.6% and 79.5% respectively, and diagnostic test accuracy was 73.7%. Conclusion. The presence of nucleated red blood cells in the complete blood count test with absent of hematopathology associated with severe hypoxia and/or increased release of cytokines, and can be used as a mortality predictor.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.041 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.012 | 0.051 |
| Bibliometrics | 0.005 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".