使用基于血液的生物标志物预测过渡到精神疾病的预后模型:系统审查和批判性评估
Jonah F Byrne1,2, David Mongan3,4, Jennifer Murphy3
1Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland. jonahbyrne21@rcsi.ie.
Translational psychiatry
|October 29, 2023
概括
血液生物标志物显示出预测精神病障碍过渡的潜力. 然而,目前的模型需要进一步验证,因为在预测模型中存在高偏差风险和方法限制.
科学领域:
- 神经科学是一个神经科学.
- 生物标志物 生物标志物
- 精神病学是一个精神病学.
背景情况:
- 患有精神疾病的个人表现出代谢和炎症异常.
- 基于血液的预测因素越来越多地用于风险人群中精神病过渡的模型.
研究的目的:
- 系统地审查使用血液生物标志物的预后模型的性能和方法,以预测高风险个体的精神病障碍.
- 评估现有预测模型的质量和适用性.
主要方法:
- 在PubMed,EMBASE和PsycINFO数据库 (1998-2023) 中进行了系统的搜索.
- 包括17项研究 (16项开发,1项验证).
- 数据提取使用了批判性评估和预测建模研究 (CHARMS) 系统审查数据提取的检查清单.
- 偏差风险和适用性使用预测模型偏差风险评估工具 (PROBAST) 进行评估.
- 进行了对发现的叙述综合.
主要成果:
- 评估了各种各样的生物标志物 (核酸,蛋白质,代谢物,脂质).
- 模型性能各不相同,C指数估计在0.67至1.00之间.
- 没有研究评估模型校准.
- 根据PROBAST标准,所有已识别的模型都被评估为在分析领域具有高偏差风险.
- 在大多数模型性能估计中,过度装配没有得到充分的解决.
结论:
- 虽然许多血液生物标志物显示出预测精神病的潜力,但目前的模型存在重大方法限制和偏差的高风险.
- 缺乏外部验证和过度装配的不适当处理妨碍了准确的性能估计.
- 未来的研究必须遵守报告准则,并采用强大的方法,包括足够的样本大小,以澄清血液生物标志物在精神病预测中的临床效用.
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