title: Simplified Mortality Score for the Intensive Care Unit (SMS-ICU): protocol for the development and validation of a bedside clinical prediction rule.
abstract: Mortality prediction scores are widely used in intensive care units (ICUs) and in research, but their predictive value deteriorates as scores age. Existing mortality prediction scores are imprecise and complex, which increases the risk of missing data and decreases the applicability bedside in daily clinical practice. We propose the development and validation of a new, simple and updated clinical prediction rule: the Simplified Mortality Score for use in the Intensive Care Unit (SMS-ICU).
  
  
  
  During the first phase of the study, we will develop and internally validate a clinical prediction rule that predicts 90-day mortality on ICU admission. The development sample will comprise 4247 adult critically ill patients acutely admitted to the ICU, enrolled in 5 contemporary high-quality ICU studies/trials. The score will be developed using binary logistic regression analysis with backward stepwise elimination of candidate variables, and subsequently be converted into a point-based clinical prediction rule. The general performance, discrimination and calibration of the score will be evaluated, and the score will be internally validated using bootstrapping. During the second phase of the study, the score will be externally validated in a fully independent sample consisting of 3350 patients included in the ongoing Stress Ulcer Prophylaxis in the Intensive Care Unit trial. We will compare the performance of the SMS-ICU to that of existing scores.
  
  
  
  We will use data from patients enrolled in studies/trials already approved by the relevant ethical committees and this study requires no further permissions. The results will be reported in accordance with the Transparent Reporting of multivariate prediction models for Individual Prognosis Or Diagnosis (TRIPOD) statement, and submitted to a peer-reviewed journal.
authors.affiliation: Department of Intensive Care 4131, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
authors.forename: Anders
authors.identifier: 0000-0001-5799-7655
authors.initials: A
authors.lastname: Granholm
authors.affiliation: Department of Intensive Care 4131, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.|Centre for Research in Intensive Care, Copenhagen, Denmark.
authors.forename: Anders
authors.initials: A
authors.lastname: Perner
authors.affiliation: Department of Intensive Care 4131, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
authors.forename: Mette
authors.initials: M
authors.lastname: Krag
authors.affiliation: Department of Intensive Care 4131, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
authors.forename: Peter Buhl
authors.initials: PB
authors.lastname: Hjortrup
authors.affiliation: Department of Intensive Care 4131, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
authors.forename: Nicolai
authors.initials: N
authors.lastname: Haase
authors.affiliation: Department of Intensive Care 4131, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
authors.forename: Lars Broksø
authors.initials: LB
authors.lastname: Holst
authors.affiliation: Department of Intensive Care 4131, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
authors.forename: Søren
authors.initials: S
authors.lastname: Marker
authors.affiliation: Department of Intensive Care 4131, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
authors.forename: Marie Oxenbøll
authors.initials: MO
authors.lastname: Collet
authors.affiliation: Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Aksel Karl Georg
authors.initials: AK
authors.lastname: Jensen
authors.affiliation: Department of Intensive Care 4131, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
authors.forename: Morten Hylander
authors.initials: MH
authors.lastname: Møller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003422:Critical Care; D016638:Critical Illness / Q000401:mortality; D003661:Decision Support Techniques; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D011379:Prognosis; D012720:Severity of Illness Index; D055815:Young Adult
keywords: INTENSIVE & CRITICAL CARE