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不要被误导:关于临床预测模型外部验证的3个误解
Hannah M la Roi-Teeuw1, Florien S van Royen1, Anne de Hond2
1Department of General Practice and Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, 3584CX, Utrecht, The Netherlands.
Journal of clinical epidemiology
|May 10, 2024
概括
在实施之前,临床预测模型的外部验证并不总是足够或需要. 了解其局限性是有效在医疗保健中部署模型的关键.
科学领域:
- 临床流行病学临床流行病学
- 生物统计学 生物统计学
- 医疗信息学 医疗信息学
背景情况:
- 临床预测模型 (CPM) 对于患者护理和决策至关重要.
- 由于缺乏外部验证,CPM的广泛实施受到阻碍.
- 外部验证通常被认为是CPM实施的先决条件.
研究的目的:
- 挑战外部验证对于CPM实施总是足够或必要的概念.
- 澄清围绕外部验证研究的作用和解释的常见误解.
- 为在CPM的背景下考虑,设计和解释外部验证提供指导.
主要方法:
- 基于临床预测模型研究中常见实践和挑战的概念分析和论证.
- 讨论关于外部验证设计,必要性和多重性的三个普遍误解.
- 综合洞察力,为模型验证和实施提供最佳实践信息.
主要成果:
- 外部验证既不是保证足够的条件,也不是CPM实施的绝对要求.
- 没有单一的推设计用于验证;上下文至关重要.
- 外部验证并不总是必要的,有时可能需要多个外部验证.
- 现有的外部验证不应该被自动解释为实施许可.
结论:
- 重新考虑对外部验证的严格要求可以促进实施有价值的CPM.
- 对于研究人员和临床医生来说,对外部验证的作用有细微的理解是必不可少的.
- 这篇论文旨在改善临床实践中对外部验证的深思熟虑的应用和解释.
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