外部验证简要的解决不明原因事件预测规则严重的潜在诊断的规则
Nassr Nama1, Ye Shen2, Jeffrey N Bone2
1Division of Hospital Medicine, Department of Pediatrics, University of Washington, Seattle Children's Hospital, Seattle.
新的预测规则对短暂解决的不明原因事件 (BRUE) 显示在识别婴儿严重诊断时比AAP标准更准确. 这些经过验证的规则为临床决策提供了更精确的工具.
科学领域:
- 儿科 儿科 儿科
- 临床决策支持 临床决策支持
- 诊断的准确性 诊断的准确性
背景情况:
- 美国儿科学会 (AAP) 对短暂解决的不明原因事件 (BRUE) 的高风险标准具有较低的积极预测价值,并错误地分类了大多数婴儿.
- 在美国队列中开发的新BRUE预测规则显示了更好的歧视,但需要外部验证.
研究的目的:
- 在加拿大队列中对新的BRUE预测规则进行外部验证.
- 将新的BRUE预测规则的性能与AAP高风险标准进行比较.
主要方法:
- 追溯的多中心队列研究,对1岁以下的婴儿进行BRUE.
- 2017年至2021年间,从加拿大11家医院收集的数据,随访90天.
- 分析的重点是确定严重的潜在诊断和事件复发.
主要成果:
- 根据AAP标准,超过90%的婴儿被错误地归类为较高风险,具有较低的积极预测值 (4.8%).
- 修订后的BRUE预测规则实现了严重诊断的AUC为0.71,超过了AAP标准 (AUC0.53).
- BRUE预测规则显示事件复发的AUC为0.67,而AAP标准的AUC为0.58.
结论:
- 在外部验证中,BRUE预测规则在外部验证中表现优于AAP高风险标准.
- 再校准进一步提高了BRUE预测规则的性能.
- 这些经过验证的规则为临床医生和家庭在管理BRUE方面提供了更精确的工具.
更多相关视频
14:27Identification of Disease-related Spatial Covariance Patterns using Neuroimaging Data
Published on: June 26, 2013
10:02Event Related Potentials ERPs and other EEG Based Methods for Extracting Biomarkers of Brain Dysfunction: Examples from Pediatric Attention Deficit/Hyperactivity Disorder ADHD
Published on: March 12, 2020
相关概念视频
Data Validation
Nursing assessment guides are generally based on holistic models rather than medical...
Formulating and Validating Nursing Diagnosis II
Risk nursing diagnoses represent clinical judgments of an individual, family, or community more vulnerable to developing the health problem than others...
Formulating and Validating Nursing Diagnosis I
There are thirteen domains...
Documentation of Nursing Diagnosis
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters...
Diagnostic and Statistical Manual of Mental Disorders (DSM)
Sensitivity, Specificity, and Predicted Value
Sensitivity is the...
