预测模型用于预测多发性硬化症患者的临床疾病进展,恶化和活动
Kelly Reeve1, Begum Irmak On2, Joachim Havla3
1Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zurich, Switzerland.
The Cochrane database of systematic reviews
|September 8, 2023
概括
多发性硬化症 (MS) 的预后模型显示出希望,但缺乏足够的独立验证以供临床使用. 需要更严格的外部验证研究来确保其可靠性和在患者护理中的适用性.
科学领域:
- 神经学 神经学
- 生物统计学 生物统计学
- 医疗信息学 医疗信息学
背景情况:
- 多发性硬化症 (MS) 是一种慢性中枢神经系统炎症性疾病,进展变化.
- 改变疾病的治疗方法正在进步,需要准确的预后工具.
- 预后模型可以帮助治疗决策和临床试验解释,但缺乏广泛的临床采用.
研究的目的:
- 识别和总结多变量预后模型,用于预测MS成年人的临床疾病进展,恶化和活动.
- 审查这些预后模型的验证研究.
主要方法:
- 在 MEDLINE,Embase 和 Cochrane 图书馆 (1996-2021) 的系统文献搜索.
- 包括统计开发的多变量预后模型及其对MS结果的验证研究.
- 数据提取,偏差风险评估 (PROBAST) 和报告质量评估 (TRIPOD).
主要成果:
- 在57项研究中确定了75个模型,外部验证有限 (15项研究,12个模型).
- 在大多数模型开发和验证中,特别是在统计分析中,注意到存在偏差的高风险.
- 预测因素,结果和报告缺陷存在显著的异质性,阻碍了可用性和可重复性.
结论:
- 目前MS的预后模型缺乏足够的独立外部验证以进行常规临床使用.
- 摩洛哥州的研究界必须遵守报告和方法指南.
- 对于现有和新模型来说,广泛的,最先进的外部验证研究至关重要.
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