儿童国际IgA病预测工具的验证,基于中国西南地区的数据
Xixi Yu1, Jiacheng Li2, Chengrong Tao1
1Department of Nephrology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.
Frontiers in pediatrics
|July 10, 2023
概括
儿童免疫球蛋白A脏病 (IgAN) 的国际预测工具在中国队列中显示出有限的有效性. 需要进一步的研究来开发针对中国儿科Igan患者的量身定制的预测模型.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 儿科脏疾病儿童脏疾病
- 医学中的预测建模.
背景情况:
- 免疫球蛋白A脏病 (IgAN) 是儿科损伤的常见原因,具有显著的进展率到末期脏病 (ESKD).
- 早期预测和干预对于管理儿童IGAN和预防长期损伤至关重要.
- 这项研究旨在验证在一组中国儿童中对Igan的现有国际预测工具.
研究的目的:
- 在一组中国儿童中评估国际IGAN预测工具的预测性能.
- 评估工具的准确性,无论是否考虑种族差异.
- 确定现有的成人衍生IGAN预测模型对儿科人口的适用性.
主要方法:
- 建立了一个外部验证队列,包括210名被诊断患有Igan的中国儿童.
- 使用曲线下的面积 (AUC),预测间隔 (PI),生存分析和R2D评估了两个模型 (带有和没有比赛) 的预测性能.
- 关键的结果指标包括膜过率 (GFR) 降低30%或进展到ESKD.
主要成果:
- 具有种族的模型的AUC为0.685和没有种族的模型是0.640,表明适度的预测能力.
- 这两种模型都显示出显著的预测间隔 (PI > 0.751),但在生存分析中,它们很难有效地区分低风险和高风险组.
- 模型匹配率为66.5%,包括种族,56.2%没有种族,这表明适用性的局限性.
结论:
- 国际IGAN预测工具主要基于成年人的数据,在这个中国儿童队列中表现不佳.
- 导出和验证队列之间的人口,临床和病理特征的差异可能解释了有限的适用性.
- 建议使用来自中国儿科Igan群的特定数据开发新的,量身定制的预测模型.
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