What evidence was available regarding the MAGGIC risk score tool?
The MAGGIC risk score was reported in multiple studies, with an AUC ranging from 0.69 to 0.78. Sensitivity and specificity data on this tool was available from the same large cohort mentioned above. Sensitivity at the threshold of 20% predicted mortality was somewhat higher (69.7%), indicating that at this threshold, the tool identified most of the patients who were at higher risk of death. However, at this threshold the MAGGIC score also labelled a significant proportion of patients as at high risk of death who did not die within the year (false positives) (the specificity of the tool was only 61%). The MAGGIC data was also at high risk of bias due to poor calibration, suggesting that the absolute predicted risks from the tool did not align well with the observed risks in the population.