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Published on: March 22, 2012
A clinically actionable nomogram for predicting invasive pulmonary aspergillosis: a nested case-control study
Lunfang Tan1, Qiaorui Zhou1, Xiang Luo1
1National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Medical Mycology
|July 31, 2026
Summary
This study developed a new nine-variable nomogram to predict invasive pulmonary aspergillosis (IPA) risk, aiding early diagnosis and treatment for this life-threatening infection.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Pulmonary Medicine
Background:
- Invasive pulmonary aspergillosis (IPA) is a severe fungal infection with high mortality.
- Non-specific symptoms and lack of early prediction models hinder timely treatment.
Purpose of the Study:
- To identify independent risk factors for IPA.
- To develop and validate a clinical nomogram for early IPA risk prediction.
Main Methods:
- A nested case-control study of 27,100 pulmonary infection patients over 10 years.
- Multivariable logistic regression used to build a nomogram in a training set (70%) and validated in a testing set (30%).
- Model performance assessed using Area Under the Curve (AUC), calibration, and Decision Curve Analysis (DCA).
Main Results:
- Nine independent IPA predictors identified: bronchiectasis, pulmonary tuberculosis, diabetes, positive serum galactomannan (GM), mechanical ventilation, connective tissue disease, positive serum (1,3)-β-D-glucan (G), sputum, and neutrophil-to-lymphocyte ratio.
- The nomogram showed moderate discrimination (AUC: 0.73 training, 0.75 testing) and excellent calibration.
- DCA confirmed the nomogram's clinical utility across various risk thresholds.
Conclusions:
- A novel nine-variable nomogram using routine clinical data offers a practical tool for early IPA risk estimation.
- This tool can potentially guide timely clinical decisions and improve patient outcomes.
- External validation of the nomogram is recommended.