动脉瘤下arachnoid出血的临床预测模型:一个系统性审查更新
Archie Parekh1, Samarth Satish1, Louise Dulhanty2
1The University of Manchester, Manchester, UK.
Journal of neurointerventional surgery
|December 21, 2023
概括
动脉瘤下关节出血 (aSAH) 的临床预测模型显示出有希望的结果,但往往具有高偏差风险. 虽然外部验证的模型正在出现,但对于可靠的aSAH结果预测,需要进一步改进方法.
科学领域:
- 神经学 神经学
- 临床流行病学临床流行病学
- 医疗信息学 医疗信息学
背景情况:
- 之前的审查强调了动脉瘤下关节出血 (aSAH) 预测模型的不良方法和缺乏外部验证.
- 这项研究更新了2011年的审查,以指导未来对aSAH的预测模型的开发.
研究的目的:
- 系统地审查和评估aSAH患者功能结果的临床预测模型的质量.
- 在SAH预测模型开发中确定常用的方法,变量和验证实践.
主要方法:
- 在Embase和MEDLINE的系统文献搜索 (2010年1月 - 2022年2月).
- 使用PRISMA,CHARMS和PROBAST检查清单进行研究选择,数据提取和偏差评估.
- 包括报告在aSAH中的功能结果预测模型开发的研究.
主要成果:
- 来自22项研究的29个预测模型被审查,涉及30,466名患者.
- 物流回归和机器学习是常见的建模技术.
- 经常包含的变量是年龄,WFNS等级,费舍尔等级和格拉斯哥昏迷表;外部验证很少 (4项研究).
- 大多数模型由于性能差或缺乏验证而表现出高或不清楚的偏差风险.
结论:
- 现在可以使用外部验证的模型来预测aSAH患者的功能结果.
- 然而,这些模型中的大多数仍然存在显著的偏差风险,表明需要改进方法.
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