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在资源有限的环境中预测住院儿童死亡率的儿科预后模型:一项外部验证研究
Morris Ogero1,2, John Ndiritu1, Rachel Sarguta1
1Department of Mathematics University of Nairobi Nairobi Kenya.
Health science reports
|August 30, 2023
概括
对RISC-Malawi等预后模型的外部验证显示,它们低估了死亡风险. 这些模型需要重新校准,以便在新的临床环境中可靠使用.
科学领域:
- 临床流行病学临床流行病学
- 生物统计学 生物统计学
- 健康研究成果研究结果
背景情况:
- 预测模型有助于临床决策,但往往缺乏外部验证.
- 可靠性和通用性的不确定性阻碍了它们的广泛应用.
- 本研究解决了对现有模型进行外部验证的需求.
研究的目的:
- 在外部验证四个预后模型,包括RISC-马拉维模型.
- 评估这些模型在新人群中的可转移性和临床实用性.
- 确定需要对模型进行重新校准以提高可通用性.
主要方法:
- 利用临床信息网络 (CIN) 的数据进行外部验证.
- 包括163329名符合条件的患者,其主要结局是住院死亡率.
- 在数据归算后,使用区分 (AUC) 和校准 (斜率,截取) 评估模型性能.
主要成果:
- RISC-马拉维模型显示AUC为0.77,而Lowlavaar等研究人员显示AUC为0.77. 这些模型的AUC值为0.75.
- 所有经过验证的模型都显示了校准问题,明显低估了死亡风险.
- 病例死亡率为RISC-马拉维的8.7%,为Lowlavaar等的5.3%. 模型. 模型.
结论:
- 外部验证的模型显示,死亡风险被严重低估.
- 当前的模型可能无法在最初的开发环境之外使用.
- 再校准对于提高这些预后模型的通用性和临床适用性至关重要.
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