成年人急性术后疼痛的预后临床预测模型:系统性审查
Nicholas Papadomanolakis-Pakis1, Philip V Munch2, Nicolai Carlé3
1Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark.
Anaesthesia
|September 16, 2024
概括
现有的急性术后疼痛预测模型显示偏差的高风险,限制了它们的可靠性. 进一步的开发应该考虑预期使用和预期的结果,以改善手术疼痛管理的临床实践.
科学领域:
- 疼痛管理 疼痛管理
- 临床预测模型临床预测模型
- 外科手术的结果
背景情况:
- 术后的急性疼痛往往没有得到充分的治疗.
- 预后风险预测模型旨在识别患有中度至严重手术后疼痛高风险的患者.
研究的目的:
- 系统地审查和评估现有的急性术后疼痛预测模型的方法质量.
主要方法:
- 在MEDLINE,EMBASE和CINAHL系统搜索预后风险预测模型.
- 评估模型性能 (歧视,校准) 和遵守TRIPOD指南.
- 使用标准化工具评估偏差风险和适用性.
主要成果:
- 14项研究报告了17种预测模型;常见的预测因素包括年龄,手术类型,手术前疼痛和焦虑.
- 模型歧视 (c-统计) 从0.61到0.83不等;只有七个模型报告了校准.
- 遵守TRIPOD指南的中位数为62%;所有模型都表现出高偏差风险.
结论:
- 虽然有效的预测模型可以帮助预防和治疗术后疼痛,但当前模型的偏差高风险会影响可靠性.
- 在开发之前,仔细考虑模型目标,时间和预期结果至关重要,以提高临床效用.
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