Risk prediction models for feeding intolerance in patients with enteral nutrition: a systematic review and meta-analysis
BackgroundAlthough more risk prediction models are available for feeding intolerance in enteral-nourishment patients, it is still unclear how well these models will work in clinical settings. Future research faces challenges in validating model accuracy across populations, enhancing interpretability...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Nutrition |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2024.1522911/full |
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| author | Huijiao Chen Jin Han Jing Li Jianhua Xiong Dong Wang Mingming Han Yuehao Shen Wenli Lu |
| author_facet | Huijiao Chen Jin Han Jing Li Jianhua Xiong Dong Wang Mingming Han Yuehao Shen Wenli Lu |
| author_sort | Huijiao Chen |
| collection | DOAJ |
| description | BackgroundAlthough more risk prediction models are available for feeding intolerance in enteral-nourishment patients, it is still unclear how well these models will work in clinical settings. Future research faces challenges in validating model accuracy across populations, enhancing interpretability for clinical use, and overcoming dataset limitations.ObjectiveTo thoroughly examine studies that have been published on feeding intolerance risk prediction models for enteral nutrition patients.DesignConducted a systematic review and meta-analysis of observational studies.MethodsA comprehensive search of the literature was conducted using a range of databases, including China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), SinoMed, PubMed, Web of Science, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Embase. The search scope was confined to articles within the database from its inception until August 12th, 2024. The data from the selected studies should be extracted, including study design, subjects, duration of follow-up, data sources, outcome measures, sample size, handling of missing data, continuous variable handling methods, variable selection, final predictors, model development and performance, and form of model presentation. The applicability and bias risk were evaluated using the Prediction Model Risk of Bias Assessment Tool (PROBAST) checklist.ResultsA total of 1,472 studies were retrieved. Following the selection criteria, 18 prediction models sourced from 14 studies were incorporated into this review. In the field of model construction, only one study employed the use of multiple machine-learning techniques for the development of a model. In contrast, the remaining studies used logistic regression to construct FI risk prediction models. The incidence of FI in enteral nutrition was 32.4–63.1%. The top five predictors included in the model were APACHE II, age, albumin levels, intra-abdominal pressure, and mechanical ventilation. The reported AUC, or area under the curve, exhibited a range of values between 0.70 and 0.921. All studies were identified as having a high risk of bias, primarily due to the use of inappropriate data sources and inadequate reporting within the analysis domain.ConclusionAlthough the included studies reported a certain degree of discriminatory power in their predictive models to identify feeding intolerance in patients undergoing enteral nutrition, the PROBAST assessment tool deemed all the included studies to carry a significant risk of bias. Future research should emphasize the development of innovative predictive models. These endeavors should incorporate more extensive and diverse sample sizes, adhere to stringent methodological designs, and undergo rigorous multicenter external validation to ensure robustness and generalizability.Systematic review registrationIdentifier CRD42024585099, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=585099. |
| format | Article |
| id | doaj-art-742ca2dea1214c0aaf87e519a4beae5b |
| institution | Kabale University |
| issn | 2296-861X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| spelling | doaj-art-742ca2dea1214c0aaf87e519a4beae5b2025-01-14T05:10:36ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-01-011110.3389/fnut.2024.15229111522911Risk prediction models for feeding intolerance in patients with enteral nutrition: a systematic review and meta-analysisHuijiao Chen0Jin Han1Jing Li2Jianhua Xiong3Dong Wang4Mingming Han5Yuehao Shen6Wenli Lu7Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, ChinaBackgroundAlthough more risk prediction models are available for feeding intolerance in enteral-nourishment patients, it is still unclear how well these models will work in clinical settings. Future research faces challenges in validating model accuracy across populations, enhancing interpretability for clinical use, and overcoming dataset limitations.ObjectiveTo thoroughly examine studies that have been published on feeding intolerance risk prediction models for enteral nutrition patients.DesignConducted a systematic review and meta-analysis of observational studies.MethodsA comprehensive search of the literature was conducted using a range of databases, including China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), SinoMed, PubMed, Web of Science, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Embase. The search scope was confined to articles within the database from its inception until August 12th, 2024. The data from the selected studies should be extracted, including study design, subjects, duration of follow-up, data sources, outcome measures, sample size, handling of missing data, continuous variable handling methods, variable selection, final predictors, model development and performance, and form of model presentation. The applicability and bias risk were evaluated using the Prediction Model Risk of Bias Assessment Tool (PROBAST) checklist.ResultsA total of 1,472 studies were retrieved. Following the selection criteria, 18 prediction models sourced from 14 studies were incorporated into this review. In the field of model construction, only one study employed the use of multiple machine-learning techniques for the development of a model. In contrast, the remaining studies used logistic regression to construct FI risk prediction models. The incidence of FI in enteral nutrition was 32.4–63.1%. The top five predictors included in the model were APACHE II, age, albumin levels, intra-abdominal pressure, and mechanical ventilation. The reported AUC, or area under the curve, exhibited a range of values between 0.70 and 0.921. All studies were identified as having a high risk of bias, primarily due to the use of inappropriate data sources and inadequate reporting within the analysis domain.ConclusionAlthough the included studies reported a certain degree of discriminatory power in their predictive models to identify feeding intolerance in patients undergoing enteral nutrition, the PROBAST assessment tool deemed all the included studies to carry a significant risk of bias. Future research should emphasize the development of innovative predictive models. These endeavors should incorporate more extensive and diverse sample sizes, adhere to stringent methodological designs, and undergo rigorous multicenter external validation to ensure robustness and generalizability.Systematic review registrationIdentifier CRD42024585099, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=585099.https://www.frontiersin.org/articles/10.3389/fnut.2024.1522911/fullenteral nutritionfeeding intolerancerisk prediction modelsystematic reviewmeta-analysis |
| spellingShingle | Huijiao Chen Jin Han Jing Li Jianhua Xiong Dong Wang Mingming Han Yuehao Shen Wenli Lu Risk prediction models for feeding intolerance in patients with enteral nutrition: a systematic review and meta-analysis Frontiers in Nutrition enteral nutrition feeding intolerance risk prediction model systematic review meta-analysis |
| title | Risk prediction models for feeding intolerance in patients with enteral nutrition: a systematic review and meta-analysis |
| title_full | Risk prediction models for feeding intolerance in patients with enteral nutrition: a systematic review and meta-analysis |
| title_fullStr | Risk prediction models for feeding intolerance in patients with enteral nutrition: a systematic review and meta-analysis |
| title_full_unstemmed | Risk prediction models for feeding intolerance in patients with enteral nutrition: a systematic review and meta-analysis |
| title_short | Risk prediction models for feeding intolerance in patients with enteral nutrition: a systematic review and meta-analysis |
| title_sort | risk prediction models for feeding intolerance in patients with enteral nutrition a systematic review and meta analysis |
| topic | enteral nutrition feeding intolerance risk prediction model systematic review meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2024.1522911/full |
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