预测失眠治疗结果的预测模型:系统性审查
Emma Holler1, Yu Du1, Cristina Barboi2
1Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, IN, USA.
Journal of psychiatric research
|December 23, 2023
概括
目前的失眠治疗预测模型缺乏外部验证. 需要更严格的,经过验证的模型来帮助临床医生个性化失眠治疗策略,以获得更好的患者结果.
科学领域:
- 医疗信息学 医疗信息学
- 睡眠医学 睡眠医学
- 临床流行病学临床流行病学
背景情况:
- 失眠是一种普遍的睡眠障碍,影响全球数百万人.
- 预测模型可以帮助将失眠治疗量身定制,以满足个体患者的需求.
- 目前用于预测成年人治疗反应的模型需要进行批判性评估.
研究的目的:
- 系统地识别和评估现有的成年人失眠治疗反应预测模型.
- 评估这些模型的方法质量和验证状态.
主要方法:
- 在PubMed,EMBASE和PsychInfo数据库 (2000年1月至2023年1月) 进行了全面的文献搜索.
- 数据提取遵循了CHecklist对批判性评估和数据提取对系统性审查预测建模研究 (CHARMS) 的指导方针.
- 通过使用预测模型研究风险偏差评估工具 (PROBAST) 来评估研究质量.
主要成果:
- 十一项研究产生了53种不同的预测模型.
- 常见的结局指标包括睡眠开始后的觉醒和失眠严重程度指数.
- 关于睡眠的功能障碍信念 (DBAS) 评分是常见的预测因素.
- 模型性能各不相同 (R2 0.060.80,AUC 0.730.87),但只有两个模型经过内部验证,没有一个被外部验证.
- 所有模型都表现出高偏差风险,主要是由于分析问题.
结论:
- 虽然预测模型显示了引导失眠治疗选择的潜力,但目前的选择因缺乏外部验证而受到限制.
- 关于失眠的方法学上健全和外部验证的预测模型,文献中存在很大的差距.
- 开发和验证强大,严格的模型对于临床应用至关重要.
更多相关视频
04:33Author Spotlight: Unveiling the Connection Between Sleep Disorders and Cognitive Symptoms in Depression
Published on: April 26, 2024
706
04:59Heat-sensitive Moxibustion as a Traditional Chinese Medicine Therapy for Chronic Obstructive Pulmonary Disease Combined with Insomnia
Published on: May 30, 2025
258
相关概念视频
Management of Insomnia
254
The sleep cycle, an integral part of human health, consists of several stages with distinct characteristics and functions. It begins with a transition from wakefulness to sleep, known as the light sleep phase, followed by the restorative deep sleep phase, essential for physical recovery and growth. The cycle concludes with the Rapid Eye Movement (REM) phase, characterized by high brain activity and vivid dreaming. Insomnia, a prevalent sleep disorder, involves difficulty falling asleep, staying...
254
Insomnia
87
Insomnia is a prevalent sleep disorder characterized by difficulty falling asleep, frequent awakenings during the night, and waking up too early without being able to return to sleep. People with insomnia often experience these disruptions at least three nights a week for at least one month. Chronic insomnia, which lasts for at least three months, can lead to increased anxiety, which in turn can worsen sleep difficulties, creating a cycle of sleeplessness and stress.
Multiple factors contribute...
Multiple factors contribute...
87
Sedatives and Hypnotics Drugs: Miscellaneous Agents
178
Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
178
Blind Procedures
10.6K
Ideally, the people who observe and record the children’s behavior are unaware of who was assigned to the experimental or control group, in order to control for experimenter bias. Experimenter bias refers to the possibility that a researcher’s expectations might skew the results of the study. Remember, conducting an experiment requires a lot of planning, and the people involved in the research project have a vested interest in supporting their hypotheses. If the observers knew which...
10.6K
Insufficient Sleep and Sleep Deprivation
146
Insufficient sleep refers to not getting the recommended amount of sleep for optimal functioning, even if it's just slightly less than needed. Sleep insufficiency may occur due to lifestyle choices, such as staying up late for social events or work, resulting in routinely getting less sleep than required. For example, consistently sleeping 6 hours when the body needs 7-9 hours can lead to cumulative effects on health and well-being.
Sleep deprivation is a more severe form of sleep loss...
Sleep deprivation is a more severe form of sleep loss...
146
Sedatives and Hypnotics: Overview
392
Sedatives are drugs that alleviate anxiety, while hypnotics induce sleep. Both classes of medication suppress neuronal activity, leading to a calming effect for sedatives and facilitating sleep for hypnotics.
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
392
