脳卒中患者におけるディスファギーの予測スワロースコアの外部検証
Salman Ikramuddin1, Martin Weiss2, Abhigyan Datta3
1Department of Neurology, University of Minnesota; Department of Neurology, University of Texas Health Sciences Houston.
まとめ
PRESSモデル (Predictive Swallow Score) は,米国のコホートにおける脳卒中後の消化不全の回復を正確に予測できませんでした. モデルのパフォーマンスの低下と脳卒中ケアにおける潜在的な違いのために,さらなる検証が必要である.
科学分野:
- 神経学 神経学とは
- クリニカル・メディシン 臨床医学
- リハビリテーション リハビリテーション
背景:
- ストローク後消化不全 (PSD) は,急性性缺血性脳卒中 (AIS) の後の頻繁な合併症であり,飲み込み機能の回復に影響を及ぼします.
- PSDの回復を予測することは困難であり,信頼性の高い予後モデルが必要である.
- スイスで開発されたPredictive Swallow Score (PRESS) モデルは,PSDの回復を予測することを目的としています.
研究 の 目的:
- 米国の患者コホートにおけるスワロウ回復を予測するPRESSモデルのパフォーマンスを検証する.
- 新しい集団におけるPRESSモデルの精度と校正を評価する.
主な方法:
- 149人の急性性不全性脳卒中患者と機能性経口摂取量スケール (FOIS) ≤4の患者の遡及的レビュー.
- 収集されたPRESS予測指標:年齢,NIHストロークスケール (NIHSS),any2スコア,ストロックの位置,初期FOISスコア.
- Hosmer-Lemeshowテスト,校正グラフ,第7日のアウトカムに対するAUC分析を使用してモデルを検証しました.
主要な成果:
- PRESSモデルは,米国のコホートで不適切なフィット (p<0.00001) と校正 (切断=-0.80,傾き=0.60) を示した.
- 曲線下の面積 (AUC) は0.75で,7日目のスローの回復を予測するためのサブ最適の差別を示しました.
- このモデルは,より高いPRESSスコアとより重度の脳卒中を持つ患者における食不全の重さを過剰に予測した.
結論:
- PRESSモデルは,この米国のコホートで最適でないパフォーマンスを示し,脳卒中後の失調症の回復を正確に予測できませんでした.
- 脳卒中治療のタイミングの違い,地理的な変動,および研究設計の違いが,モデルの性能の低下を説明する可能性があります.
- 脳卒中の治療における潜在的な進歩と地域での実践の違いを考慮して,さらなる将来的な検証が推奨されます.
関連する概念動画
Reliability and Validity
14.1K
Reliability and validity are two important considerations that must be made with any type of data collection. Reliability refers to the ability to consistently produce a given result. In the context of psychological research, this would mean that any instruments or tools used to collect data do so in consistent, reproducible ways.
14.1K
Introduction to z Scores
11.3K
A z score (or standardized value) is measured in units of the standard deviation. It tells you how many standard deviations the value x is above (to the right of) or below (to the left of) the mean, μ. Values of x that are larger than the mean have positive z scores, and values of x that are smaller than the mean have negative z scores. If x equals the mean, then x has a zero z score. It is important to note that the mean of the z scores is zero, and the standard deviation is one.
z scores...
z scores...
11.3K
Introduction to z Scores
1.4K
A z score (or standardized value) is measured in units of the standard deviation. It indicates how many standard deviations the value x is above (to the right of) or below (to the left of) the mean, μ. Values of x that are larger than the mean have positive z scores, and values of x that are smaller than the mean have negative z scores. If x equals the mean, then x has a zero z score. It is important to note that the mean of the z scores is zero, and the standard deviation is one.
z scores...
z scores...
1.4K
z Scores and Area Under the Curve
19.7K
z scores are the standardized values obtained after converting a normal distribution into a standard normal distribution. A z score is measured in units of the standard deviation. The z score tells you how many standard deviations the value x is above (to the right of) or below (to the left of) the mean, μ. Values of x that are larger than the mean have positive z scores, and values of x that are smaller than the mean have negative z scores. If x equals the mean, then x has a z score of...
19.7K
Upper GI Series: Barium Swallow
1.8K
The Barium Swallow Study, or a Barium Esophagogram, is a diagnostic imaging method used to visualize the upper gastrointestinal (GI) tract, including the esophagus, stomach, and small intestine. It employs barium sulfate, a radiopaque contrast material, to provide clear images of the upper digestive system, helping to identify abnormalities, diseases, or structural issues.
Purpose and Procedure
Patients undergoing this procedure ingest a liquid containing barium sulfate with a chalky...
Purpose and Procedure
Patients undergoing this procedure ingest a liquid containing barium sulfate with a chalky...
1.8K
Work Done on a System by External Force
3.0K
The work done by an external force on a particle changes its kinetic energy. However, internal forces must also be considered for a system of interacting particles. The potential energy formulation helps formulate the effect of internal forces. The net work done by an external force can be written in terms of the total change of mechanical energy, which includes both kinetic and potential energies.
In the presence of a non-conservative opposing force, like friction, some part of the work done...
In the presence of a non-conservative opposing force, like friction, some part of the work done...
3.0K


