{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T19:18:27Z","timestamp":1793215107485,"version":"4.5.0"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T00:00:00Z","timestamp":1714435200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>To systematically assess and compare the predictive value of the Ranson and Bedside Index of Severity in Acute Pancreatitis (BISAP) scoring systems for the severity and prognosis of acute pancreatitis (AP).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>PubMed, Embase, Cochrane Library, and Web of Science were systematically searched until February 15, 2023. Outcomes in this analysis included severity and prognosis [mortality, organ failure, pancreatic necrosis, and intensive care unit (ICU) admission]. The revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to evaluate the quality of diagnostic accuracy studies. The threshold effect was evaluated for each outcome. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and the area under the summary receiver operating characteristic (SROC) curve (AUC) as well as 95% confidence intervals (CI) were calculated. The DeLong test was used for AUC comparisons. For the outcome evaluated by over 9 studies, publication bias was assessed using the Deeks\u2019 funnel plot asymmetry test.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Totally 17 studies of 5476 AP patients were included. For severity, the pooled sensitivity of the Ranson and BISAP was 0.95 (95%CI: 0.87, 0.98) and 0.67 (95%CI: 0.27, 0.92); the pooled specificity of the Ranson and BISAP was 0.74 (0.52, 0.88) and 0.95 (95%CI: 0.85, 0.98); the pooled AUC of the Ranson and BISAP was 0.95 (95%CI: 0.93, 0.97) and 0.94 (95%CI: 0.92, 0.96) (<jats:italic>P<\/jats:italic> = 0.480). For mortality, the pooled sensitivity of the Ranson and BISAP was 0.89 (95%CI: 0.73, 0.96) and 0.77 (95%CI: 0.58, 0.89); the pooled specificity of the Ranson and BISAP was 0.79 (95%CI: 0.68, 0.87) and 0.90 (95%CI: 0.86, 0.93); the pooled AUC of the Ranson and BISAP was 0.91 (95%CI: 0.88, 0.93) and 0.92 (95%CI: 0.90, 0.94) (<jats:italic>P<\/jats:italic> = 0.480). For organ failure, the pooled sensitivity of the Ranson and BISAP was 0.84 (95%CI: 0.76, 0.90) and 0.78 (95%CI: 0.60, 0.90); the pooled specificity of the Ranson and BISAP was 0.84 (95%CI: 0.63, 0.94) and 0.90 (95%CI: 0.72, 0.97); the pooled AUC of the Ranson and BISAP was 0.86 (95%CI: 0.82, 0.88) and 0.90 (95%CI: 0.87, 0.93) (<jats:italic>P<\/jats:italic> = 0.110). For pancreatic necrosis, the pooled sensitivity of the Ranson and BISAP was 0.63 (95%CI: 0.35, 0.84) and 0.63 (95%CI: 0.23, 0.90); the pooled specificity of the Ranson and BISAP was 0.90 (95%CI: 0.77, 0.96) and 0.93 (95%CI: 0.89, 0.96); the pooled AUC of the Ranson and BISAP was 0.87 (95%CI: 0.84, 0.90) and 0.93 (95%CI: 0.91, 0.95) (<jats:italic>P<\/jats:italic> = 0.001). For ICU admission, the pooled sensitivity of the Ranson and BISAP was 0.86 (95%CI: 0.77, 0.92) and 0.63 (95%CI: 0.52, 0.73); the pooled specificity of the Ranson and BISAP was 0.58 (95%CI: 0.55, 0.61) and 0.84 (95%CI: 0.81, 0.86); the pooled AUC of the Ranson and BISAP was 0.92 (95%CI: 0.81, 1.00) and 0.86 (95%CI: 0.67, 1.00) (<jats:italic>P<\/jats:italic> = 0.592).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The Ranson score was an applicable tool for predicting severity and prognosis of AP patients with reliable diagnostic accuracy in resource and time-limited settings. Future large-scale studies are needed to verify the findings.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0302046","type":"journal-article","created":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T17:30:18Z","timestamp":1714498218000},"page":"e0302046","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":46,"title":["Predictive value of the Ranson and BISAP scoring systems for the severity and prognosis of acute pancreatitis: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5620-231X","authenticated-orcid":true,"given":"Jianpeng","family":"Zhu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linfei","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengdie","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofeng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,4,30]]},"reference":[{"issue":"11","key":"pone.0302046.ref001","doi-asserted-by":"crossref","first-page":"2024","DOI":"10.1136\/gutjnl-2016-313595","article-title":"Acute pancreatitis: recent advances through randomised trials","volume":"66","author":"SM van Dijk","year":"2017","journal-title":"Gut"},{"issue":"8","key":"pone.0302046.ref002","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1038\/s41575-019-0158-2","article-title":"New insights into acute pancreatitis","volume":"16","author":"PJ Lee","year":"2019","journal-title":"Nat Rev Gastroenterol Hepatol"},{"issue":"2","key":"pone.0302046.ref003","doi-asserted-by":"crossref","first-page":"Itc17","DOI":"10.7326\/AITC202102160","article-title":"Acute Pancreatitis","volume":"174","author":"TB Gardner","year":"2021","journal-title":"Ann Intern Med"},{"issue":"4","key":"pone.0302046.ref004","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1001\/jama.2020.20317","article-title":"Acute Pancreatitis: A Review","volume":"325","author":"MA Mederos","year":"2021","journal-title":"Jama"},{"issue":"1","key":"pone.0302046.ref005","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1136\/gutjnl-2012-302779","article-title":"Classification of acute pancreatitis\u20142012: revision of the Atlanta classification and definitions by international consensus","volume":"62","author":"PA Banks","year":"2013","journal-title":"Gut"},{"issue":"10252","key":"pone.0302046.ref006","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1016\/S0140-6736(20)31310-6","article-title":"Acute pancreatitis","volume":"396","author":"L Boxhoorn","year":"2020","journal-title":"Lancet"},{"issue":"1","key":"pone.0302046.ref007","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1186\/s13613-022-01072-y","article-title":"Intravenous fluid therapy in patients with severe acute pancreatitis admitted to the intensive care unit: a narrative review","volume":"12","author":"A Crosignani","year":"2022","journal-title":"Ann Intensive Care"},{"issue":"16","key":"pone.0302046.ref008","doi-asserted-by":"crossref","first-page":"e15275","DOI":"10.1097\/MD.0000000000015275","article-title":"Severity stratification and prognostic prediction of patients with acute pancreatitis at early phase: A retrospective study","volume":"98","author":"H Zhou","year":"2019","journal-title":"Medicine (Baltimore)"},{"issue":"8","key":"pone.0302046.ref009","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1080\/17474124.2021.1924058","article-title":"Ranson score to stratify severity in Acute Pancreatitis remains valid\u2014Old is gold","volume":"15","author":"Y Ong","year":"2021","journal-title":"Expert Rev Gastroenterol Hepatol"},{"issue":"6","key":"pone.0302046.ref010","first-page":"443","article-title":"Objective early identification of severe acute pancreatitis","volume":"61","author":"JH Ranson","year":"1974","journal-title":"Am J Gastroenterol"},{"issue":"9","key":"pone.0302046.ref011","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.1111\/jgh.13763","article-title":"BISAP, RANSON, lactate and others biomarkers in prediction of severe acute pancreatitis in a European cohort","volume":"32","author":"F Valverde-L\u00f3pez","year":"2017","journal-title":"J Gastroenterol Hepatol"},{"issue":"6","key":"pone.0302046.ref012","first-page":"1619","article-title":"The APACHE III prognostic system. 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