用于预测中等大小 (1-2厘米) 结石的治疗结果的诺姆图的外部验证
Maria C Sighinolfi1, Tommaso Calcagnile1,2, Marco Ticonosco2
1Department of Urology, ASST Santi Paolo e Carlo, Milan, Italy.
Minerva urology and nephrology
|May 10, 2024
概括
预测结石治疗失败的Micali's nomogram在不同人群的外部验证中显示出更低的准确性. 需要进一步的前性研究来完善其对冲击波石,RIRS和PNL的临床实用性.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 腎臟病學 (nephrology) 是一種醫學專業.
- 医疗信息学 医疗信息学
背景情况:
- 在2605名患者身上开发的Micali's nomogram准确地预测了对1-2厘米结石 (AUC 0.793) 的冲击波石流症 (SWL),逆行性内外科手术 (RIRS) 和皮肤结石切除术 (PNL) 的治疗失败.
- 外部验证对于在不同患者群体和临床环境中评估名图的预测性能至关重要.
研究的目的:
- 为了外部验证米卡利的诺米克图,用于预测在接受SWL,RIRS和PNL治疗结石的患者中治疗失败.
- 评估nomogram的预测准确性和校准性,当应用到来自不同地理区域的新一组患者时.
主要方法:
- 意大利,美国,西班牙和阿根廷的26个中心3025名患者的回顾性外部验证 (2010年12月 - 2021年6月).
- 收集的数据包括患者的人口统计,石头特征和手术前条件.
- 治疗失败被定义为手术后三个月CT扫描上的残留碎片>4毫米.
主要成果:
- 在外部验证队列中,名图显示了中度的歧视,ROC曲线下的面积为0.66 (95% CI 0.59-0.68).
- 该模型在外部验证数据集中显示了适当的校准.
- 局限性包括回顾性质和对亚洲,非洲或大洋洲人口潜在的普遍性缺乏.
结论:
- 在SWL,RIRS和PNL中,米卡利的名录可以用于治疗预测,但与内部验证相比,歧视性减少了.
- 地理,时间和域名限制会影响名ogram在外部验证中的表现.
- 建议进行进一步的前性研究,以完善名谱并确认其临床价值.
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