在晚期癌症患者的生存预测的预后模型:系统性审查和元分析
Mong Yung Fung1, Yuen Lung Wong2, Ka Man Cheung3
1Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China. myfung@link.cuhk.edu.hk.
BMC palliative care
|March 2, 2025
概括
这一系统性审查发现,息性预后得分 (PaP) 可能是预测晚期癌症患者生存率的有用工具. 需要进一步的研究来证实它对息护理计划的有效性.
科学领域:
- 在瘤学瘤学.
- 抚慰性护理是一种缓解性护理.
- 生物统计学 生物统计学
背景情况:
- 准确的预后对于晚期癌症的息护理 (PC) 计划至关重要.
- 临床点治疗预后模型可以帮助临床医生做出决策.
- 及时的PC转诊会影响患者的治疗结果,但在实践中是不同的.
研究的目的:
- 系统地审查和分析晚期癌症存活率的预后模型.
- 识别和评估各种临床预后工具的性能.
- 为选择息护理决策支持模型提供信息.
主要方法:
- 在主要数据库 (Ovid Medline,Embase,CINAHL Ultimate,Scopus) 进行系统的文献搜索.
- 纳入标准:不可治愈的固体瘤,预后模型验证,性能测量.
- 使用PROBAST评估的偏差风险;用于生存预测的聚合C统计数据的元分析.
主要成果:
- 35项研究评估了35种预后模型;缓性预后指数 (PPI),缓性预后得分 (PaP) 和目标预后得分 (OPS) 是常见的.
- 在30天生存期的C统计数据:PPI=0.68,PaP=0.76,OPS=0.69.
- 在21天 (0.80) 和30天 (0.76) 的生存预测中,PaP显示出更高的C统计数据.
- 所有纳入的研究都显示出高偏差风险.
结论:
- 息预后得分 (PaP) 显示了对生存预后的有希望的表现.
- 需要进一步的验证和实施研究.
- 当前研究中存在偏差的高风险需要谨慎的解释.
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