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开发和验证一个预测模型,用成人患者的点滴尿样来估计24小时尿液分泌量
Miriam Menacho-Roman1, Martin Fabregate-Fuente2, Laura Caja-Guayerbas1
1Clinical Biochemistry Department, Hospital Universitario Ramón y Cajal, IRYCIS. Madrid, Spain.
概括
从点尿样本中估计24小时的尿路分泌是可能的,但变化意味着它是不可能的.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临床化学 临床化学
- 公共卫生 公共卫生
背景情况:
- 精确测量24小时尿液分泌量对于评估平衡和管理健康状况至关重要.
- 传统的24小时尿液采集方法容易出现错误和患者不遵守规定.
- 斑点尿 (uNa) 为估计分泌提供了一个潜在的更方便的替代方案.
研究的目的:
- 评估使用成人医院诊所患者的点尿样估计24小时尿液分泌量 (24uNa) 的可行性.
- 开发和验证一个预测模型,用于点滴尿估计.
主要方法:
- 采用了横截面的研究设计,涉及开发队列 (n=284) 和验证队列 (n=229).
- 构建了一个多变量线性回归模型 (NaRYC),并与以前的模型进行了比较.
- 根据130 mmol/24h的截止值对一致性分析和分类准确性进行了评估,使用C-统计.
主要成果:
- 开发的NaRYC模型在内部验证中表现出良好的校准和区分 (斜率:0.965) 和在外部验证中表现强 (斜率:0.811).
- 与其他七个方程相比,NaRYC模型显示出更高的性能,具有最高的皮尔森系数 (0.613),精度 (56.8%) 和AUC-ROC (0.822).
- 测量和估计的24uNa之间的平均偏差为24.85 mmol/24h,被认为是可以接受的.
结论:
- 虽然NaRYC模型显示出从点样中估计24小时尿液分泌量的前景,但其一般使用是谨慎的.
- 在95%置信区间中观察到的变异性表明,点滴尿估计可能不足以用于个体对象评估.
- 可能需要进一步的研究,以完善从点尿样中准确估计个人分泌的方法.
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