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基于表征的依赖时间的共变量,改进了生存分析,以预测个体慢性病进展情况
Chen-Mao Liao1, Chuan-Tsung Su2, Hao-Che Huang1
1Department of Applied Statistics and Information Science, Ming Chuan University, Taoyuan 333, Taiwan.
Biomedicines
|June 28, 2023
概括
预测慢性病 (CKD) 的进展至关重要. 一个随机生存森林模型准确地确定了慢性病患者功能衰竭的危险因素,如肌素和年龄.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 医疗信息学 医疗信息学
- 生物统计学 生物统计学
背景情况:
- 脏疾病对全球健康造成重大负担,需要有效识别预防和治疗的危险因素.
- 早期发现和治疗慢性病 (CKD) 的进展对于降低发病率和死亡率至关重要.
研究的目的:
- 为了比较3个依赖时间的存活模型的预测性表现,用于3-5期CKD患者的功能衰竭.
- 确定关键的临床和人口特征,以最佳预测CKD进展.
主要方法:
- 台湾497名3-5阶段的CKD患者的队列在3个月的临床测量中被跟踪了3年.
- 采用了三个生存模型Cox比例危险模型 (Cox PHM),随机生存森林 (RSF) 和人工神经网络 (ANN).
- 模型性能使用一致性索引,灵敏度和特异性进行评估,通过Kaplan-Meier估计进行验证.
主要成果:
- 随机生存森林 (RSF) 模型表现出优异的预测性能,一致性指数为0.89,与Cox PHM (0.71) 和ANN (0.72) 相比.
- 在预测3年内CKD进展的过程中,RSF获得了0.79的灵敏度和0.88的特异性.
- 由RSF确定的关键预测因素包括肌,年龄,估计的淋巴膜过率和尿蛋白与肌的比例.
结论:
- 随机生存森林模型为CKD进展提供了强大而准确的预测.
- 肌素,年龄,eGFR和UPCR是预测CKD患者功能衰竭的重要因素.
- 这些发现支持在常规CKD患者随访中使用RSF进行即时风险评估.
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