Evidence mapPaperPMID 42563185Full record

ArticleJournal of intensive care2026

Early prediction of intensive care unit-acquired weakness using quadriceps ultrasound and routine clinical variables: development and temporal validation of a prospective multicentre machine-learning model.

Tongjuan Zou, Xuehua Chen, Jun Li, Xianying Lei, Hengyu Cai, Li Zhang, Li Zhang, Xueying Zeng, Qionglan Dong, Shurong Zhang and 6 more

Abstract read
In one paragraph

Article in Journal of intensive care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Tongjuan ZouDepartment of Critical Care Medicine, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Wuhou District, Chengdu, People's Republic of China.
Xuehua ChenDepartment of Critical Care Medicine, Fourth People's Hospital of Zigong City, Zigong, People's Republic of China.
Jun LiDepartment of Critical Care Medicine, The First People's Hospital of Longquanyi District, Chengdu, People's Republic of China.
Xianying LeiDepartment of Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, People's Republic of China.
Hengyu CaiDepartment of Critical Care Medicine, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Wuhou District, Chengdu, People's Republic of China.
Li ZhangDepartment of Critical Care Medicine, West China School of Public Health and West China Fourth Hospital of Sichuan University, Chengdu, People's Republic of China.
Li ZhangDepartment of Critical Care Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, People's Republic of China.
Xueying ZengDepartment of Critical Care Medicine, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Wuhou District, Chengdu, People's Republic of China.
Qionglan DongDepartment of Critical Care Medicine, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, People's Republic of China.
Shurong ZhangDepartment of Critical Care Medicine, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Wuhou District, Chengdu, People's Republic of China.
Yan KangDepartment of Critical Care Medicine, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Wuhou District, Chengdu, People's Republic of China.
Bo WangDepartment of Critical Care Medicine, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Wuhou District, Chengdu, People's Republic of China.
Zhongwei ZhangDepartment of Critical Care Medicine, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Wuhou District, Chengdu, People's Republic of China.
Xiaodong JinDepartment of Critical Care Medicine, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Wuhou District, Chengdu, People's Republic of China.
Wanhong YinDepartment of Critical Care Medicine, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Wuhou District, Chengdu, People's Republic of China. yinwanhong@wchscu.cn.ORCID http://orcid.org/0000-0001-8188-7747
Critical Care Ultrasound Study Group (CCUSG)

Funding

Project for Horizontal Research, West China Hospital, Sichuan University 311241641Sichuan Province Science and Technology Support Program-Key Research & Development Project 2024YFFK0052
6 · The paper itself

Abstract

backgroundIntensive care unit-acquired weakness (ICUAW) is frequent in critically ill adults and is associated with adverse outcomes, but early recognition is difficult because standard diagnosis relies on volitional strength testing.

methodsIn this prospective multicentre cohort study across 16 tertiary ICUs in southwest China, adults expected to remain in the ICU for ≥ 3 days underwent quadriceps ultrasound and routine clinical assessment within 24 h of admission. ICUAW was defined by the first evaluable Medical Research Council (MRC) score during ICU stay. We developed and compared nine algorithms in a development cohort (n = 858) and performed temporal external validation in a later cohort (n = 345).

resultsICUAW occurred in 579/858 (67.5%) patients in the development cohort and 181/345 (52.5%) in the validation cohort. In external validation, a random forest model integrating unpressurised ultrasound and clinical features achieved an area under the receiver operating characteristic curve (AUC) of 0.810 (95% CI 0.765-0.855), with sensitivity 0.983 (0.952-0.997) and specificity 0.726 (0.651-0.792). The corresponding pressurised-ultrasound model showed lower discrimination (AUC 0.730 [0.676-0.783]) and specificity (0.506 [0.427-0.585]). Shapley additive explanations (SHAP) highlighted quadriceps muscle thickness, Sequential Organ Failure Assessment (SOFA) score, albumin, and inflammatory markers as key contributors. In additional incremental-value analyses using the General RF model as the reference, the unpressurised RF model improved risk reclassification and discrimination (cf-NRI 0.490, 95% CI 0.277-0.698; IDI 0.072, 95% CI 0.045-0.099), whereas the pressurised RF model showed a smaller cf-NRI improvement (0.231, 95% CI 0.011-0.463) with less consistent IDI improvement (0.019, 95% CI - 0.002 to 0.040).

conclusionsThis early ultrasound-clinical model may identify patients at high risk of ICUAW before strength testing becomes feasible and support earlier targeting of preventive and rehabilitation strategies. Trial registration Registered in the Chinese Clinical Trial Registry (ChiCTR2300075581) on September 8, 2023.

Indexed as

Intensive care unitsMachine learningMuscle weaknessRisk assessmentUltrasonography

Identifiers

PMID42563185
PMCPMC13445787

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.