Reporting and methods in developing prognostic prediction models for metabolic syndrome: A systematic review and critical appraisal

Abstract

Purpose: A prognostic prediction model for metabolic syndrome can calculate the prob- ability of risk of experiencing metabolic syndrome within a specific period for individualized treatment decisions. We aimed to provide a systematic review and critical appraisal on prognostic models for metabolic syndrome. Materials and Methods: Studies were identified through searching in English databases (PubMed, EMBASE, CINAHL, and Web of Science) and Chinese databases (Sinomed, WANFANG, CNKI, and CQVIP). A checklist for critical appraisal and data extraction for systematic reviews of prediction modeling studies (CHARMS) and the prediction model risk of bias assessment tool (PROBAST) were used for the data extraction process and critical appraisal. Results: From the 29,668 retrieved articles, eleven studies meeting the selection criteria were included in this review. Forty-eight predictors were identified from prognostic predic- tion models. The c-statistic ranged from 0.67 to 0.95. Critical appraisal has shown that all modeling studies were subject to a high risk of bias in methodological quality mainly driven by outcome and statistical analysis, and six modeling studies were subject to a high risk of bias in applicability. Conclusion: Future model development and validation studies should adhere to the trans- parent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD) statement to improve methodological quality and applicability, thus increasing the transparency of the reporting of a prediction model study. It is not appropriate to adopt any of the identified models in this study for clinical practice since all models are prone to optimism and overfitting.