在血栓切除术后不完全再输血的患者中持续输血缺陷模型的外部验证:EXTEND-PROCEED
Adnan Mujanovic1, Felix C Ng1, Mattia Branca1
1From the Departments of Diagnostic and Interventional Neuroradiology (A.M., E.I.P., T.D., J.G., J.K.), Neurology (T.R.M., M.A., D.J.S., U.F.), University Hospital Bern, Inselspital, Graduate School for Health Sciences (A.M.), and CTU Bern (M.B.), University of Bern, Switzerland; Department of Medicine and Neurology, Melbourne Brain Centre (F.C.N., N.Y., G.J.S., B.C.V.C.), Melbourne Medical School (L.C.), and Department of Radiology (P.J.M.), Royal Melbourne Hospital, University of Melbourne, Parkville; Department of Neurology (F.C.N.), Austin Health, Heidelberg, Australia; Division of Neuroradiology, Vascular and Interventional Radiology Department of Radiology (H.A.D., O.N., T.G., M.K.), and Department of Neurology (T.G., M.K.), Medical University of Graz, Austria; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville; Department of Neurology (M.W.P.), Liverpool Hospital, University of New South Wales, Sydney, Australia; Department of Radiology and Nuclear Medicine (F.C.), Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Neuroscience, the Netherlands; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; and Department of Neurology (U.F.), University Hospital Basel, University of Basel, Switzerland.
在中风血栓切除术后,PROCEED模型准确地预测了持续的 perfusion deficit (PPD). 外部验证证实其能够指导医生进行进一步的再注射尝试,从而减少不必要的干预.
科学领域:
- 神经学 神经学
- 放射学 放射学是一门学科.
- 医疗成像医学成像
背景情况:
- 开发了一个预测模型,PROCEED,用于在血栓切除术后24小时识别持续的输液缺陷 (PPD).
- 这种缺陷发生在血管学转输不完整的患者中.
研究的目的:
- 为了外部验证 PROCEED 模型.
- 用前性获取的多中心数据来评估其性能.
主要方法:
- 来自三个试验/队列的数据被用于验证.
- 主要结局是PPD,通过24小时的特定 perfusion 成像标准来定义.
- 用歧视,校准和临床决策曲线来评估模型性能.
主要成果:
- PROCEED模型表现出良好的区分 (C统计值0.81) 和适当的校准.
- 临床决策曲线显示了跨越各种概率值的净收益.
- 该模型可以减少13%的不必要干预,而不会错过PPD病例.
结论:
- 外部验证的PROCEED模型显示了足够的预测准确性和歧视性.
- 它可以帮助医生根据PPD的可能性决定进一步的再输血尝试.


