Conduct and reporting of studies developing pre-endoscopic prognostic scores in upper gastrointestinal bleeding: a methodological systematic review.
Pierre-Clément Thiebaud, Agathe Beauvais, Manon Fainelli et al.
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In 30 seconds
This systematic review assessed the methods and reporting of studies developing or modifying pre-endoscopic prognostic scores for patients with upper gastrointestinal bleeding (UGIB). Across 41 studies describing 43 scores, populations, outcomes, and analytic approaches varied substantially. Most studies were single-centre and retrospective; among newly developed scores, logistic regression with predictor selection based on univariate significance was common. Only 33% reported calibration and 39% performed internal validation. Overall, 93% of studies were judged at high risk of bias, highlighting concerns about the reliability and transparency of the evidence underpinning these scores.
Key findings
- The review included 41 studies reporting 43 distinct pre-endoscopic UGIB prognostic scores.
- Most studies were single-centre (76%) and retrospective (63%), with substantial variation in populations and outcomes.
- Only 33% of studies reported calibration measures, and 39% performed internal validation.
- Overall, 93% of studies were classified as having a high risk of bias.
Why it matters
Pre-endoscopic scores may inform risk assessment and decisions about care setting or urgency, but their usefulness depends on sound development and transparent reporting. The review found widespread methodological concerns and heterogeneity, so reported scores may not be equally reliable or applicable across UGIB populations. Better-designed and reported studies are needed to support confidence in these tools.
What to keep in mind
The review evaluated study methods and reporting, not comparative score performance; substantial heterogeneity in populations and outcomes also limits direct comparison.