在西方内镜中心预测结直肠内镜膜下切割的程序持续时间
Hao Dang1, Nik Dekkers1, Ewout W Steyerberg2
1Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, Netherlands.
Endoscopy international open
|November 9, 2023
概括
准确预测结直肠内镜膜下切割 (ESD) 程序时间至关重要. 这项研究验证了东方模型,并开发了一个新的cESD-TIME公式,为西方中心的时间规划提供了改进的工具.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 医疗信息学 医疗信息学
背景情况:
- 准确预测结直肠内镜膜下切割 (ESD) 程序时间对于后勤规划至关重要.
- 预测ESD持续时间的现有模型需要在不同的临床环境中进行评估.
研究的目的:
- 评估现有的东方预测模型对结直肠ESD持续时间的性能.
- 开发和验证一种新的,更准确的预测模型,用于结直肠ESD手术时间.
主要方法:
- 来自荷兰中心的435个结直肠ESD手术的回顾性分析.
- 东方预测模型的验证和多变量线性回归模型 (cESD-TIME) 的开发.
- 在瑞典队列中进行内部验证 (引导式,交叉验证) 和外部验证.
主要成果:
- 东方模型在预测ESD<60分钟 (c-统计值0.70) 时表现适度,在<120分钟 (c-统计值0.75) 时表现改善.
- 新的6个变量cESD-TIME公式显示出强大的预测准确性 (乐观度调整后R2=61%).
- 目前的时间安排实践不足于最佳,仅解释了27%的程序持续时间差异.
结论:
- 两个经过验证的工具,包括cESD-TIME公式,提高了对西方中心结直肠ESD持续时间的预测.
- 这些工具可以帮助优化时间规划,克服结直肠ESD的后勤挑战.
- 建议进一步验证和本地调整预测模型.
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