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一个具有竞争力的风险预测模型,用于晚期慢性病患者的功能衰竭
Tai-Shuan Lai1, Hsiao-Mei Tsao2, Yu-Hsiang Chou1
1Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Journal of the Formosan Medical Association = Taiwan yi zhi
|December 3, 2023
概括
这项研究开发了一种新的模型,使用现实世界的数据预测晚期慢性病 (CKD) 患者的衰竭. 该模型准确识别高风险个体,有助于对病进展的早期干预.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 生物统计学 生物统计学
- 流行病学 流行病学
背景情况:
- 预测建模对于识别高风险出现不良健康事件的患者至关重要.
- 功能衰竭是慢性病 (CKD) 患者的一个显著不良事件.
- 常规收集的数据为开发临床预测模型提供了宝贵的资源.
研究的目的:
- 开发和验证一个具有竞争力的风险预测模型,用于晚期CKD患者的功能衰竭.
- 利用现实世界的数据,为一个实用和适用的预测工具.
- 为了估计功能衰竭的亚危险比率,同时将死亡作为一个竞争事件.
主要方法:
- 总共有5138名患有CKD3b-5阶段的患者被纳入.
- 患者被随机分配到发展 (70%) 和验证 (30%) 队列.
- 应用了Fine和Grey竞争风险模型,将功能衰竭 (透析或移植) 作为感兴趣的事件,并将死亡作为竞争事件.
主要成果:
- 最终的模型包括eGFR,年龄,性别,UPCR,血压,血清白蛋白,酸,尿酸,血红蛋白和水平.
- 模型在开发和验证队伍中都显示出强烈的歧视 (c-统计0.86-0.95).
- 预测模型对2年和5年风险预测的校准分别表现出色和良好.
结论:
- 使用现实数据的竞争性风险模型准确地预测了晚期CKD患者2年内功能衰竭的进展.
- 开发的模型在开发和验证队伍中表现良好.
- 这种工具可以帮助临床医生识别高风险患者,以便及时进行干预.
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