新诊断的患者治疗结果的临床预测模型:系统性审查
Corey Ratcliffe1,2, Vishnav Pradeep3, Anthony Marson1
1Department of Pharmacology and Therapeutics, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, UK.
Epilepsia
|April 30, 2024
概括
在新诊断的 (NDE) 中预测控制至关重要. 这次审查发现,虽然一些因素,如发作类型和病史是预测性的,但目前的预测模型具有偏差的高风险,需要改进.
科学领域:
- 神经学 神经学
- 临床流行病学临床流行病学
背景情况:
- 高达35%的患者患有耐药性,严重影响生活质量.
- 预测治疗结果对于临床管理和患者决策至关重要.
研究的目的:
- 系统地审查新诊断患者治疗结果的预测模型.
- 为了确定预测治疗反应的人口,临床,生理和成像因素.
主要方法:
- 对NDE预测模型的MEDLINE和Embase数据库进行系统审查.
- 使用PROBAST工具评估研究偏差和适用性.
- 提取与治疗结果相关的基线变量作为预后因素.
主要成果:
- 在32项研究中确定了48个模型;模型的适用性问题很低,但偏差风险很高.
- 常见的重要预测因素包括发作特征,史和发病时的年龄.
- 抗发作药物反应作为基线变量可能会混结果.
结论:
- 目前的NDE预测模型具有高偏差风险.
- 建议在模型开发中更好地遵守TRIPOD报告准则.
- 提出了可行的变化,以提高NDE预测模型的质量.
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