时间和外部验证算法预测一个可行的怀孕的第一季度结果的算法
Nicole Stamatopoulos1,2, Donna Ngo2, Chuan Lu3
1Acute Gynaecology, Early Pregnancy and Advanced Endoscopy Surgery Unit, Sydney Medical School Nepean, University of Sydney, Penrith, New South Wales, Australia.
概括
流产风险预测模型 (MRP) 在预测怀孕结果方面显示出中度准确性,但不适合实时咨询. 个性化患者管理对于早期妊娠并发症至关重要.
科学领域:
- 怀孕早期的诊断 怀孕早期的诊断
- 生殖医学是一种生殖医学.
- 临床预测建模临床预测建模
背景情况:
- 怀孕早期出血或疼痛会引起对可能流产的焦虑.
- 第一个三个月的经阴道扫描 (TVS) 超声波变量可以预测到12周的怀孕结果.
研究的目的:
- 为了验证流产风险预测模型 (MRP) 对于在初级超声波检查中确定的可行的子宫内妊娠 (IUP).
主要方法:
- 多中心诊断研究 (1490名患者) 具有追溯外部和前时间验证.
- MRP模型使用母亲的年龄,胚胎心率,妊娠囊体积/冠长度 (CRL) 比率,CRL和凝块的存在.
- 参考标准:可行的怀孕在12周+6天.
主要成果:
- 时间验证 (290个IUP):AUC为0.8,灵敏度为66.7%,特异性为83.9%,NPV为94.9%.
- 外部验证 (1203个IUP):AUC为0.7,灵敏度为44.9%,特异性为90.4%,净净值为96.2%.
- 模型性能在时间和外部验证数据集之间有所不同.
结论:
- 目前,MRP模型不适合实时临床咨询.
- 建议对患有早期妊娠并发症的患者进行个性化管理.
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