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Use TRIPOD when validating clinical prediction models
  1. Bart GJ Candel1,2,
  2. Søren Kabell Nissen3,4
  1. 1 Department of Emergency Medicine, Maxima Medical Centre, Veldhoven, The Netherlands
  2. 2 Department of Emergency Medicine, Leiden University Medical Centre, Leiden, The Netherlands
  3. 3 Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
  4. 4 Department of Emergency Medicine, Hospital South West Jutland, Esbjerg, Syddanmark, Denmark
  1. Correspondence to Dr Bart GJ Candel, Emergency Medicine, Maxima Medical Centre, 5504 DB Veldhoven, Noord-Brabant, The Netherlands; bartcandel{at}

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It is with great interest that we have read the article from Schinkel et al in which the Netherlands Triage System (NTS) was compared with the Modified Early Warning Score (MEWS) to predict hospital admission and 30-day mortality in Emergency Department (ED) patients.1 Although the results showed that the MEWS performed better than complaints-based triage in terms of discrimination, we disagree with the conclusion that MEWS may replace the NTS score for triage of patients.

The authors could have strengthened the methodology and conclusions by following the ‘transparent reporting of a multivariable prediction model for individual prognosis or diagnosis’ (TRIPOD) guidelines.2 For example, in the study by Schinkel et al, patients were excluded if no …

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  • Handling editor Kirsty Challen

  • Contributors Both authors contributed equally to this work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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