Key result
ISAT model strongly discriminates 60-day fatality with an 0.89 AUC but significantly underestimates actual risk.
Why the study?
External validation of prognostic models to predict 60-day case fatality after aneurysmal subarachnoid hemorrhage is crucial but rarely performed.
Does the ISAT prediction model accurately predict 60-day case fatality in an unselected cohort of aneurysmal subarachnoid hemorrhage patients?
Cohort (n=307)
No
Does the ISAT prediction model accurately predict 60-day case fatality in an unselected cohort of aneurysmal subarachnoid hemorrhage patients?
Effect estimate: AUC 0.89
The ISAT prediction model for 60-day case fatality after aneurysmal subarachnoid hemorrhage shows good discrimination but poor calibration in an unselected cohort, requiring adaptation for clinical use.
ISAT model underestimates fatality in unselected aSAH cohorts despite good discrimination; leaves open whether recalibration enables reliable use.
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Dijkland et al. (2016) conducted a cohort in aneurysmal subarachnoid hemorrhage (n=307). International Subarachnoid Aneurysm Trial prediction model was evaluated on 60-day case fatality (AUC 0.89). The International Subarachnoid Aneurysm Trial prediction model discriminated well for 60-day case fatality (AUC 0.89), but predicted probabilities (17.7%) were much lower than observed (30.6%).
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