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对儿童肺炎的两种临床预测模型的外部验证

Sriram Ramgopal¹, Melissa Neveu², Douglas Lorenz³

¹Division of Emergency Medicine (S Ramgopal, J Benedetti, J Lavey, and TA Florin), Ann & Robert H. Lurie Children's Hospital of Chicago, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Ill.

Academic pediatrics

|August 19, 2024

概括

肺炎风险评分 (PRS) 模型在预测儿科肺炎方面显示出比CARPE DIEM模型更好的准确性. 然而,这两种模型都还不足以用于儿童的独立临床使用.

科学领域:

儿科急救医学儿科急救医学
诊断的准确性诊断的准确性
临床预测模型临床预测模型

背景情况:

准确诊断儿科肺炎对于有效治疗至关重要.
现有的预测模型需要外部验证来评估其现实世界的性能.

研究的目的:

对肺炎风险评分 (PRS) 和CARPE DIEM模型在预测儿童放射性肺炎方面的性能进行外部验证.
评估重新校准和重新估计对模型性能的影响.

主要方法:

在儿科急诊室对202名儿童 (90天-18岁) 的前性评估.
使用原始和重新校准/重新估计的参数评估PRS和CARPE DIEM模型的性能.
通过曲线下的面积 (AUC),灵敏度和特异性评估模型性能.

主要成果:

与CARPE DIEM (AUC0.59) 相比,PRS模型显示出更高的性能 (AUC0.72).
与CARPE DIEM相比,PRS的灵敏度 (65.2%) 和特异性 (72.7%) 较高 (灵敏度为56.5%,特异性为60.9%).
再校准和重新估计提高了性能,特别是对于CARPE DIEM,提高了校准和诊断指标.

结论:

在预测儿科放射性肺炎方面,PRS模型比CARPE DIEM更有效.
目前的模型在独立临床应用之前需要进一步改进和验证.
临床判断对于诊断儿童肺炎至关重要,即使使用预测模型.

关键词:

临床预测模型的临床预测模型.在社区获得的肺炎.紧急情况部门的急救部门.儿科放射性肺炎儿科放射性肺炎肺炎风险评分肺炎风险评分

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