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简化质量结果数据库网络计算器的性能:内部和外部验证
Leah Y Carreon1, Hui Nian2, Kristin R Archer3
1Norton Leatherman Spine Center, 210 East Gray St, Suite 900, Louisville, KY, USA; Center for Spine Surgery and Research, Region of Southern Denmark, Østre Hougvej 55, DK-5500, Middelfart, Denmark; Institute of Regional Health Research, University of Southern Denmark, Winsløwparken 19, 3, DK-5000, Odense, Denmark.
质量结果数据库基于网络的计算器 (QOD-Calc) 准确地预测在类似人群中腰椎手术后患者的改善情况. 在一个不同的群体中,表现略有下降,这表明需要针对特定人群的预测模型.
科学领域:
- 脊柱外科手术研究成果 研究结果
- 医疗信息学 医疗信息学
- 医学中的预测分析.
背景情况:
- 基于网络的计算器越来越多地用于预测腰椎手术后患者的结果.
- 准确验证这些预测模型对于临床决策至关重要.
研究的目的:
- 进行减少质量成果数据库网络计算器 (QOD-Calc) 的内部和外部验证.
主要方法:
- 采用了观察纵向队列研究设计.
- 分析了24755例质量结果数据库 (QOD) 病例和8105例丹尼脊柱病例 (选择性腰椎脊柱手术) 的数据.
- 在奥斯威斯特残疾指数 (ODI),疼痛数值评分表 (NRS) 和EuroQOL-5D (EQ-5D) 中,QOD-Calc对"任何改善"和"30%改善"的预测与使用接收器操作特征分析和校准图表的12个月术后数据进行了比较.
主要成果:
- QOD-Calc在QOD队列中表现出"任何改善"的可接受到卓越的预测能力 (AUC:0.694-0.874).
- "30%改善"的预测能力在QOD队列中中度至可接受 (AUC:0.658-0.747).
- 在DaneSpine队列中,QOD-Calc在"任何改善" (AUC:0.669-0.734) 方面表现为可接受的至特殊能力,在"30%改善" (AUC:0.619-0.862) 方面表现为中度至特殊能力,AUC比QOD队列持续较低.
结论:
- QOD-Calc在预测与其发展队列相似的患者群体的结果方面表现良好.
- 模型的性能在一个独特的,尽管更均的人群中略有下降.
- 这些发现表明,预测模型可能需要根据特定的人口特征进行量身定制的开发,这可能是由于歧视门较低,大多数病例都显示出改善.
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