Selecting candidate predictor variables for the modelling of post-discharge mortality from sepsis: a protocol development project

Abstract

Background: Post-discharge mortality is a frequent but poorly recognized contributor to child mortality in resource limited countries. The identification of children at high risk for post-discharge mortality is a critically important first step in addressing this problem.

Objectives: The objective of this project was to determine the variables most likely to be associated with post-discharge mortality which are to be included in a prediction modelling study.

Methods: A two-round modified Delphi process was completed for the review of a priori selected variables and selection of new variables. Variables were evaluated on relevance according to (1) prediction (2) availability (3) cost and (4) time required for measurement. Participants included experts in a variety of relevant fields.

Results: During the first round of the modified Delphi process, 23 experts evaluated 17 variables. Forty further variables were suggested and were reviewed during the second round by 12 experts. During the second round 16 additional variables were evaluated. Thirty unique variables were compiled for use in the prediction modelling study.

Conclusion: A systematic approach was utilized to generate an optimal list of candidate predictor variables for the incorporation into a study on prediction of pediatric post-discharge mortality in a resource poor setting.

Keywords: Candidate predictor variables; pediatrics; post-discharge mortality; prediction; sepsis.

Figures

Figure 1

Flow diagram of Delphi process. * Variables included some with multiple predictors listed as single variables (eg. height/weight and vital signs). Total predictors are therefore not a sum of final variables from Round 1 and Round 2 of Delphi process.