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验证的计算器预测诱导后剖腹产:在外部人群中的准确性
Shirley J Shao1, E Nicole Teal, Adam K Lewkowitz
1School of Medicine and the Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, California; the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and the Department of Obstetrics and Gynecology, Warren Alpert Medical School at Brown University, Providence, Rhode Island.
两台用于预测分娩后剖腹产产生的计算器在外部人群中表现不佳. 他们高估了剖腹产风险,建议谨慎使用它们的广泛使用,而没有精细化.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 临床预测模型临床预测模型
背景情况:
- 对剖腹产风险的准确预测对于管理分娩诱导至关重要.
- 现有的预测计算器旨在为临床决策提供信息,但需要外部验证.
研究的目的:
- 评估两个公布的剖腹产分娩风险计算器在独立队列中的表现.
- 为了评估这些计算器在预测工资诱导后剖腹产产生的准确性.
主要方法:
- 一项队列研究包括846名无产妇患者,其中包括单子,终身,胎胎,完整的膜和不良的宫,正在进行分娩诱导.
- 预测的剖腹产风险得分是使用两个既定的计算器来计算的.
- 观察到的和预测的剖腹产率在整体和风险层之间进行了比较.
主要成果:
- 这两种计算器都大大高估了整体剖腹产率 (预计为40.0%和36.2%对比观察到的31.0%).
- 在高风险的第三种动物中,高估值尤为明显.
- 接收器运行特征曲线下的面积为≤0.57,表明预测能力差.
结论:
- 以前发表的剖腹产预测计算器在这个外部群体中表现不佳.
- 错误地高预测的风险可能会对患者和提供者关于引产的决定产生负面影响.
- 这些计算器在广泛临床实施之前需要对特定人群进行显著的细化.
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