Page 37 - Risk quantification and modification in older patients with colorectal cancer

All the outcomes were considered relevant for older patients, all the non- mortality outcomes such as anastomotic leakage, surgical complications, LARS symptoms, multiple admission (health care usage) could result in delayed recovery and decrease in HRQoL. That also included surgical site infections. Due to the inclusion of intraoperative predictors, there were applicability concerns for preoperative decision making for thirteen studies.10,15,17,19,21,22,24,25,28-31,34 The CR- POSSUM model for postoperative mortality 10 includes a peri-operative collected physiological score that cannot be calculated preoperatively. Inclusion of predictors such as intraoperative blood loss and duration of surgery,15,19,25,29,30,34 intraoperative complications,21 the distance of the anastomosis to the anal verge15,22 limits the applicability for preoperative decision making.
Table 3 Applicability concern based on the CHARM checklist
Risk prediction models for CRC patients
Applicability Concern
Participant Predictors selection
Outcome
Mortality
Tekkis et al. 10
Fazio et al. 11
Slim et al. 12
Cohen et al. 13 Farooq et al. 14 Richards et al. 16 Kiran et al. 18
Van der Sluis et al. 20 Kong et al. 23 Murray et al. 26
Anastomotic leakage Dekker et al. 15
Pasic et al. 19
Frasson et al. 21
Hu et al. 22 Rojas-Machando et al. 27 Rencuzogullari et al. 29 Hoshino et al. 33
Other outcomes Gervaz et al. 17 Vather et al. 24 Watanabe et al. 25 Bailey et al. 28 Zhang et al. 30 Battersby et al. 31 Fieber et al. 32 Shen et al. 34
L M L L L L L L L L L L L L L L L L L L L L L L L L L L L L
L M L M M L L M L L M L H L L L M L L L L
L M L L M L L L L L L L L M L L L L L L L L M L
CHARMS; checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Model Studies. Criteria listed in the Appendix B.
L, low concern; M, moderate concern; H, high concern
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