在ADHD个性化预测模型:一个系统的审查和元回归
Gonzalo Salazar de Pablo1,2,3, Raquel Iniesta4,5, Alessio Bellato6,7,8
1Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
注意缺陷/多动障碍 (ADHD) 的预测模型对诊断有希望,但需要改进才能预测结果或治疗反应. 临床预测因素提高了模型的性能,但目前没有一个模型为临床实践做好了准备.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 生物统计学 生物统计学
背景情况:
- 越来越多的努力旨在开发个性化ADHD检测,预测和治疗的预测模型.
- 目前的研究旨在系统地审查和评估现有的多动症预测模型,并评估影响其表现的因素.
研究的目的:
- 系统地审查和评估注意力缺陷/多动障碍 (ADHD) 的可用预测模型.
- 量化评估影响已发表的ADHD预测模型表现的因素.
主要方法:
- 进行了符合PRISMA/CHARMS/TRIPOD的系统性审查,搜索报告经过验证的ADHD诊断,预后或治疗反应预测模型的研究,直到2023年12月20日.
- 使用元回归来探索影响模型曲线下面积 (AUC) 的因素,预测模型偏差风险评估工具 (PROBAST) 评估了研究偏差风险.
主要成果:
- 在7764个记录中,包括100个预测模型,主要用于诊断 (88%).
- 只有8%的模型具有低偏差风险,7%的模型得到了外部验证;没有一个模型在临床上得到实施.
- 结合临床预测因素的模型显示性能有所改善 (AUC增加).
结论:
- 虽然存在许多ADHD诊断模型,但预测结果或治疗反应是有限的,没有模型准备用于临床实施.
- 临床预测因素似乎提高了预测模型的性能,这表明它们在未来模型开发中的重要性.
- 未来的研究必须专注于高质量,可复制和外部验证的模型,然后进行实施研究,以弥合临床实践的差距.
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