{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T04:12:54Z","timestamp":1790827974873,"version":"4.1.0"},"reference-count":73,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T00:00:00Z","timestamp":1695772800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Scoring systems for severe acute pancreatitis (SAP) prediction should be used in conjunction with pre\u2010test probability to establish post\u2010test probability of SAP, but data of this kind are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the predictive value of commonly employed scoring systems and their usefulness in modifying the pre\u2010test probability of SAP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Following PRISMA statement and MOOSE checklists after PROSPERO registration, PubMed was searched from inception until September 2022. Retrospective, prospective, cross\u2010sectional studies or clinical trials on patients with acute pancreatitis defined as Revised Atlanta Criteria, reporting rate of SAP and using at least one score among Bedside Index for Severity in Acute Pancreatitis (BISAP),\n                      <jats:italic>Acute Physiology and Chronic Health Examination<\/jats:italic>\n                      (APACHE)\u2010II, RANSON, and\n                      <jats:italic>Systemic Inflammatory Response Syndrome<\/jats:italic>\n                      (SIRS) with their sensitivity and specificity were included. Random effects model meta\u2010analyses were performed. Pre\u2010test probability and likelihood ratio (LR) were combined to estimate post\u2010test probability on Fagan nomograms. Pooled severity rate was used as pre\u2010test probability of SAP and pooled sensitivity and specificity to calculate LR and generate post\u2010test probability. A priori hypotheses for heterogeneity were developed and sensitivity analyses planned.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>43 studies yielding 14,116 acute pancreatitis patients were included: 42 with BISAP, 30 with APACHE\u2010II, 27 with Ranson, 8 with SIRS. Pooled pre\u2010test probability of SAP ranged 16.6%\u201325.3%. The post\u2010test probability of SAP with positive\/negative score was 47%\/6% for BISAP, 43%\/5% for APACHE\u2010II, 48%\/5% for Ranson, 40%\/12% for SIRS. In 18 studies comparing BISAP, APACHE\u2010II, and Ranson in 6740 patients with pooled pre\u2010test probability of SAP of 18.7%, post\u2010test probability when scores were positive was 48% for BISAP, 46% for APACHE\u2010II, 50% for Ranson. When scores were negative, post\u2010test probability dropped to 7% for BISAP, 6% for Ranson, 5% for APACHE\u2010II. Quality, design, and country of origin of the studies did not explain the observed high heterogeneity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The most commonly used scoring systems to predict SAP perform poorly and do not aid in decision\u2010making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ueg2.12464","type":"journal-article","created":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T10:10:59Z","timestamp":1695809459000},"page":"825-836","source":"Crossref","is-referenced-by-count":82,"title":["Clinical usefulness of scoring systems to predict severe acute pancreatitis: A systematic review and meta\u2010analysis with pre and post\u2010test probability assessment"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0019-8753","authenticated-orcid":false,"given":"Gabriele","family":"Capurso","sequence":"first","affiliation":[{"name":"Pancreato\u2010Biliary Endoscopy and Endosonography Division Pancreas Translational &amp; Clinical Research Center San Raffaele Scientific Institute IRCCS Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruggero","family":"Ponz de Leon Pisani","sequence":"additional","affiliation":[{"name":"Pancreato\u2010Biliary Endoscopy and Endosonography Division Pancreas Translational &amp; Clinical Research Center San Raffaele Scientific Institute IRCCS Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaetano","family":"Lauri","sequence":"additional","affiliation":[{"name":"Pancreato\u2010Biliary Endoscopy and Endosonography Division Pancreas Translational &amp; Clinical Research Center San Raffaele Scientific Institute IRCCS Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3979-9553","authenticated-orcid":false,"given":"Livia","family":"Archibugi","sequence":"additional","affiliation":[{"name":"Pancreato\u2010Biliary Endoscopy and Endosonography Division Pancreas Translational &amp; Clinical Research Center San Raffaele Scientific Institute IRCCS Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Hegyi","sequence":"additional","affiliation":[{"name":"Centre for Translational Medicine Semmelweis University  Budapest Hungary"},{"name":"Institute of Pancreatic Diseases Semmelweis University  Budapest Hungary"},{"name":"Translational Pancreatology Research Group Interdisciplinary Centre of Excellence for Research Development and Innovation 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