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[Development and Internal Validation of a Predictive Model for Prognostic Response to Proton Pump Inhibitors in
Sebastián Fernando Niño Ramírez1, Laura Osorio2, Marco Santisteban3
1Universidad CES, Instituto Gastroclinico, Colombia. Universidad CES Universidad CES Instituto Gastroclinico Colombia.
Introduction:
The response to proton pump inhibitor treatment in functional dyspepsia varies among patients. A decision tool that identifies the probability of response based on clinical data could optimize management in these patients.
Objective:
To develop and internally validate an easy-to-use predictive model that enables clinicians to establish the probability of response to proton pump inhibitors in patients with functional dyspepsia.
Material And Methods:
We conducted a cross-sectional study on adults with functional dyspepsia. A pilot study identified variables related to response to proton pump inhibitors. Internal validation was performed by split-sample method, with 70% for model development and 30% for validation. We developed the model using multivariable logistic regression, and selected variables based on the best subset method. The final model was subsequently transformed into a scoring rule. Predictive ability was assessed using the area under the curve (AUC) and Hosmer-Lemeshow statistic.
Results:
A total of 192 patients were included. The best subset identified 4 variables with the best performance. The logistic model showed good calibration and discrimination with an AUC of 0.89 and a Hosmer-Lemeshow chi-square test with p = 1. The scoring rule assigned the following values: anxiety symptoms (3 points), fibromyalgia (2 points), depression (1 point), and female sex (- 1 point). A total score of 4 points or less was associated with a good response to proton pump inhibitor treatment, with a sensitivity of 96.5% and specificity of 56.6%.
Conclusions:
We present a novel tool that facilitates the early identification of patients with a better therapeutic response to the management of functional dyspepsia.
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