对儿童性结肠炎疾病结果的预测模型的验证:一个多中心的潜在发病队列
Ohad Atia1,2, Renz C W Klomberg3, Lissy de Ridder3
1Shaare Zedek Medical Centre, Jerusalem, Israel.
预测儿科性结肠炎 (UC) 结果的现有模型,如PROTECT和Schechter在外部验证研究中显示出有限的准确性. 在为儿科UC患者在临床实践中实施预测模型之前,外部验证至关重要.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 炎症性肠道疾病研究研究
- 临床试验方法论 临床试验方法论
背景情况:
- 包括PROTECT,Schechter和PIBD-ahead在内的几种模型旨在预测儿科性结肠炎 (UC) 的结果.
- 然而,这些模型在外部队列中缺乏验证.
- 这项研究解决了对现有预测模型进行外部验证的需求.
研究的目的:
- 通过外部验证儿童性结肠炎 (UC) 已建立的预测模型.
- 评估 PROTECT 和 Schechter 模型在预测无类固醇缓解 (SFR) 和急性严重结肠炎 (ASC) 的准确性.
主要方法:
- 建立了一个潜在的,多中心的新诊断的儿科UC患者的初始队列.
- 患者在诊断时,3个月,12个月和最后一次访问时被跟踪.
- 测量结果包括无类固醇缓解 (SFR) 和急性严重结肠炎 (ASC).
主要成果:
- 在PROTECT模型中,SFR在3个月 (AUC0.78) 时具有良好的预测效用,但在12个月 (AUC0.57) 时没有.
- 谢赫特的标准在12个月后预测持续SFR的准确性有限 (50%的灵敏度,60%的特异性).
- 急性严重结肠炎 (ASC) 的最佳预测是儿童性结肠炎活动指数 (PUCAI) 在诊断时和3个月后的得分.
结论:
- 儿童UC结果的PROTECT模型的预测价值在12个月后显著下降.
- 现有的预测模型,如Schechter的模型,在这个外部队列中没有达到足够的准确性.
- 在儿童性结肠炎临床应用之前,对所有预测模型的外部验证至关重要.
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