{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T23:49:21Z","timestamp":1789429761959,"version":"build-2803163510"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T00:00:00Z","timestamp":1611187200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T00:00:00Z","timestamp":1611187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Educ"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The Comprehensive Osteopathic Medical Licensing Examination of the United States Level 1 (COMLEX 1) is important for medical students to be able to graduate. There is a glaring need to identify students who are at a significant risk of performing poorly on COMLEX 1 as early as possible so that extra assistance can be provided to those students. Our goal is to produce a reliable predictive model to identify students who are at risk of scoring lower than 500 on COMLEX 1 at the earliest possible time.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Academic data from medical students who matriculated at Rocky Vista University College of Osteopathic Medicine between 2011 and 2017 were obtained. Odds ratios were used to assess the predictors for scoring lower than 500 on COMLEX 1. Correlation with COMLEX 1 scores was assessed with Pearson correlation coefficient. The predictive models were developed by multiple logistic regression, backward logistic regression, and logistic regression with average scores in courses in the first three semesters, and were based on performances on the Medical College Admissions Test (MCAT) before admission, as well as students\u2019 performances in preclinical courses during the first three semesters. The models were generated in about 82% of the student performance data and were then validated in the remaining 18% of the data.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Odds ratios showed that MCAT scores and final grades in each course in the first three semesters were significant in predicting a score lower than 500 on COMLEX 1. Performances in third-semester courses including Renal System II, Cardiovascular System II, and Respiratory System II were most important in prediction. The three predictive models had sensitivities of 65.8 -71%, and specificities of 83.2 - 88.2% in predicting a score lower than 500 on COMLEX 1.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Lower MCAT scores and lower grades in the first three semesters of medical school predict scoring lower than 500 on COMLEX 1. Students who are identified at risk by our models will have a 65.8 -71% chance of actually scoring lower than 500 on COMLEX 1. Those students will have enough time to receive assistance before taking COMLEX 1.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12909-021-02501-5","type":"journal-article","created":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T11:04:06Z","timestamp":1611227046000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Early prediction of the risk of scoring lower than 500 on the COMLEX 1"],"prefix":"10.1186","volume":"21","author":[{"given":"Qing","family":"Zhong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Payton","family":"Christensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"McNeil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Linton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Payton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,1,21]]},"reference":[{"key":"2501_CR1","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-019-1669-9","volume":"19","author":"K Mitsouras","year":"2019","unstructured":"Mitsouras K, Dong F, Safaoui MN, et al. Student academic performance factors affecting matching into first-choice residency and competitive specialties. BMC Med Educ. 2019;19:241 https:\/\/doi.org\/10.1186\/s12909-019-1669-9.","journal-title":"BMC Med Educ"},{"issue":"2","key":"2501_CR2","first-page":"84","volume":"101","author":"MK Cope","year":"2001","unstructured":"Cope MK, Baker HH, Fisk RO, Gorby JN, Foster RW. Prediction of student performance on the comprehensive osteopathic medical licensing examination level I based on admission data and course performance. J Am Osteopath Assoc. 2001;101(2):84\u201390 PMID: 11293374. https:\/\/pubmed.ncbi.nlm.nih.gov\/11293374\/.","journal-title":"J Am Osteopath Assoc"},{"issue":"4","key":"2501_CR3","first-page":"175","volume":"112","author":"D Dixon","year":"2012","unstructured":"Dixon D. Prediction of osteopathic medical school performance on the basis of MCAT score, GPA, sex, undergraduate major, and undergraduate institution. J Am Osteopath Assoc. 2012;112(4):175\u201381 PMID: 22522516. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22522516.","journal-title":"J Am Osteopath Assoc"},{"issue":"2","key":"2501_CR4","doi-asserted-by":"publisher","first-page":"106","DOI":"10.7556\/jaoa.2018.025","volume":"118","author":"F Agahi","year":"2018","unstructured":"Agahi F, Speicher MR, Cisek G. Association between undergraduate performance predictors and academic and clinical performance of osteopathic medical students. J Am Osteopath Assoc. 2018;118(2):106\u201314. https:\/\/doi.org\/10.7556\/jaoa.2018.025.","journal-title":"J Am Osteopath Assoc"},{"issue":"2","key":"2501_CR5","doi-asserted-by":"publisher","first-page":"164","DOI":"10.7556\/jaoa.2013.113.2.164","volume":"113","author":"A Vora","year":"2013","unstructured":"Vora A, Maltezos N, Alfonzo L, Hernandez N, Calix E, Fernandez MI. Predictors of scoring at least 600 on COMLEX-USA level 1: successful preparation strategies. J Am Osteopath Assoc. 2013;113(2):164\u201373. https:\/\/doi.org\/10.7556\/jaoa.2013.113.2.164.","journal-title":"J Am Osteopath Assoc"},{"issue":"3","key":"2501_CR6","first-page":"153","volume":"100","author":"HH Baker","year":"2000","unstructured":"Baker HH, Cope MK, Fisk R, Gorby JN, Foster RW. Relationship of preadmission variables and first- and second-year course performance to performance on the National Board of osteopathic medical Examiners' COMLEX-USA level 1 examination. J Am Osteopath Assoc. 2000;100(3):153\u201361 PMID: 10763309. https:\/\/pubmed.ncbi.nlm.nih.gov\/10763309\/.","journal-title":"J Am Osteopath Assoc"},{"issue":"4","key":"2501_CR7","first-page":"238","volume":"100","author":"HH Baker","year":"2000","unstructured":"Baker HH, Foster RW, Bates BP, et al. Relationship between academic achievement and COMLEX-USA level 1 performance: a multisite study. J Am Osteopath Assoc. 2000;100(4):238\u201342 PMID: 10808669. https:\/\/pubmed.ncbi.nlm.nih.gov\/10808669\/.","journal-title":"J Am Osteopath Assoc"},{"issue":"10","key":"2501_CR8","first-page":"491","volume":"103","author":"DJ Sefcik","year":"2003","unstructured":"Sefcik DJ, Prozialeck WC, O'Hare TH. Characteristics of the courses that best predict COMLEX-USA level 1 performance. J Am Osteopath Assoc. 2003;103(10):491\u20134 PMID: 14620085. https:\/\/pubmed.ncbi.nlm.nih.gov\/14620085\/.","journal-title":"J Am Osteopath Assoc"},{"key":"2501_CR9","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1007\/s40670-014-0053-y","volume":"24","author":"AG Glaros","year":"2014","unstructured":"Glaros AG, Hanson A, Adkison LR. Early prediction of medical student performance on initial licensing examinations. 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Percentile ranks for the MCAT exam. https:\/\/students-residents.aamc.org\/advisors\/article\/percentile-ranks-for-the-mcat-exam\/. Accessed on 8 Aug 2020."},{"issue":"2","key":"2501_CR13","doi-asserted-by":"publisher","first-page":"128","DOI":"10.22454\/FamMed.2018.145163","volume":"50","author":"S Kim","year":"2018","unstructured":"Kim S, George P. The relationship between preclinical grading and USMLE scores in US allopathic medical schools. Fam Med. 2018;50(2):128\u201331. https:\/\/doi.org\/10.22454\/FamMed.2018.145163.","journal-title":"Fam Med"}],"container-title":["BMC Medical Education"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-021-02501-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12909-021-02501-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-021-02501-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T11:07:55Z","timestamp":1611227275000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmededuc.biomedcentral.com\/articles\/10.1186\/s12909-021-02501-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,21]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["2501"],"URL":"https:\/\/doi.org\/10.1186\/s12909-021-02501-5","relation":{},"ISSN":["1472-6920"],"issn-type":[{"value":"1472-6920","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,21]]},"assertion":[{"value":"13 October 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 January 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 January 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"<b>Ethical approval statement<\/b>: Our research project of \u201cUsing Simulation Modeling to Predict Failure on COMLEX 1 and 2 at First Attempt Through a Longitudinal Investigation\u201d was approved by IRB committee of Rocky Vista University College of Osteopathic Medicine (RVUCOM), and the IRB number was IRB #2019-0079. IRB determined the study was exempt.<b>Accordance statement for guidelines<\/b>: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.<b>Informed consent statement<\/b>: The waiver was obtained for informed consent from IRB committee of RVUCOM.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"70"}}