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 distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".