开发和外部验证多位数预测模型,以测定风湿性关节炎患者的甲状腺素治疗结果:来自国际合作的结果
Celina K Gehringer1, Glen P Martin2, Kimme L Hyrich3
1Division of Musculoskeletal and Dermatological Sciences, Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, University of Manchester, Manchester, UK; Centre for Biostatistics, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
Journal of clinical epidemiology
|December 10, 2023
概括
这项研究开发了一种新模型,用于预测类风湿性关节炎患者的甲铁治疗结果,识别那些可能患有低疾病活性或因不良事件而停止治疗的人. 该模型比不良事件更好地预测疾病活动.
科学领域:
- 类风湿病学 类风湿病学
- 临床预测建模临床预测建模
- 药物监督 药物监督 药物监督
背景情况:
- 识别高风险 (>50%) 的患者不响应一线甲状腺素 (MTX) 治疗在风湿病学中至关重要.
- 以前的预测模型往往有偏差,并且不考虑不良事件 (AE).
研究的目的:
- 开发一个多项模型,预测6个月的低疾病活性和由于AE导致的MTX中止.
- 在治疗开始3个月后,使用地标分析更新预后.
- 通过外部验证开发的模型.
主要方法:
- 使用来自英国风湿关节炎药物研究的数据开发了一个多项模型.
- 标志性分析被用于预后更新.
- 内部验证使用了引导,外部验证在挪威疾病修饰性抗风湿药物注册表中进行.
- 用校准和歧视指标评估模型性能.
主要成果:
- 内部验证的模型显示了良好的校准和适度的歧视,用于预测低疾病活性.
- 预测AE的歧视程度较低.
- 外部验证显示预测性能下降,可能是由于患者群体和结果流行率的差异.
结论:
- 该研究解决了MTX预测模型中的方法限制.
- 与AE相比,多项方法在预测疾病活动结果方面显示出更高的准确性.
- 未来的研究应该专注于改善临床实施AE预测.
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