在临床毒理学中应用诺米克图 - - 提高临床决策准确性:系统性审查
Asmaa Fady Sharif1,2, Zeinab A Kasemy3, Khalid Saeed Alshalawi4
1Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Critical reviews in toxicology
|February 13, 2025
概括
本综述总结了38种用于预测急性中毒病例结果的诺姆图. 虽然许多名图表显示出高准确度,但大多数缺乏外部验证,突出了临床应用的研究机会.
科学领域:
- 临床毒理学 临床毒理学
- 医疗信息学 医疗信息学
背景情况:
- 诺米图是预测急性中毒结果的宝贵工具.
- 现有的名ograms往往是零星地开发,限制他们的临床实用性.
- 需要进行系统审查,以巩固和指导这些预测工具的实施.
研究的目的:
- 提供一个全面的参考指南,用于在临床毒理学中实施名ograms.
- 审查用于急性中毒管理的诺姆图的开发,验证和应用.
- 识别研究缺陷,特别是在名ograms的外部验证.
主要方法:
- 60年来发表的27项研究的系统审查,包括60,883名患者.
- 分析了38个开发的名录,根据一般中毒或特定物质 (杀虫剂,精神药物,酒精等) 分类它们. ) 的情况.
- 使用接收器操作特征分析和对外部验证工作的评估来评估名ogram性能.
主要成果:
- 确定了38个名ograms,在2016年后的出版物显著增加.
- 常见的预测因素包括格拉斯哥昏迷量表,年龄,毒素度,二碳酸盐和血压.
- 诺米图预测死亡率,ICU入院和并发症等结果,报告的AUC范围从0.839到0.999.
- 只有16个名录经过验证,只有一个被独立研究外部验证.
结论:
- 诺米图显示了各种急性中毒结果的高预测性能.
- 缺乏广泛的外部验证,阻碍了许多名ograms的普遍适用性.
- 专注于外部验证的进一步研究对于加强这些预测工具的临床采用至关重要.
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