使用临床风险模型来预测结果:我们在预测什么以及为什么?
1School of Health and Related Research, The University of Sheffield, Sheffield, S10 2TN, UK s.goodacre@sheffield.ac.uk.
Emergency medicine journal : EMJ
|July 19, 2023
概括
临床风险预测模型可能会错误地识别那些不太可能从治疗中受益的患者. 本文解释了治疗效应如何影响模型开发,并提供了使用预测得分来帮助临床决策的指导.
科学领域:
- 紧急医疗 紧急医疗
- 临床流行病学临床流行病学
- 生物统计学 生物统计学
背景情况:
- 临床风险预测模型对于紧急医疗决策至关重要.
- 目前的模型可能不准确地将干预措施指向高风险患者.
- 治疗效应对模型开发的影响往往被忽视.
研究的目的:
- 检查治疗效应对预后临床风险预测模型的影响.
- 识别治疗效应如何导致错误分类患者益处.
- 为适当使用临床预测得分提供实用建议.
主要方法:
- 预后模型开发的概念分析.
- 检查治疗效应引入的潜在偏差.
- 关于临床预测得分应用的文献综述.
主要成果:
- 治疗效应可以导致风险预测模型识别不太可能从干预中受益的患者.
- 模型可能无法识别最有可能受益的患者,从而阻碍了有效的资源配置.
- 对模型输出的误解可能导致不理想的临床决策.
结论:
- 临床医生应该意识到治疗效应可能导致风险预测模型的偏差.
- 临床预测得分应该增强,而不是取代临床判断.
- 需要仔细考虑模型开发和应用,以确保对患者的好处.
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