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多病症患者死亡风险预测模型:系统性审查和元分析
Yuan-Yuan Chen1, Mei-Fen Ji2, Li-Hong Jin3
1Department of Otorhinolaryngology, Organization Lishui People's Hospital, Lishui, Zhejiang, China.
Frontiers in public health
|April 17, 2025
概括
这一系统性审查发现,虽然风险预测模型在多病症患者中显示出预测死亡率的能力,但大多数患者具有显著的偏差风险. 未来的研究需要严格的设计和外部验证,以提高准确性.
科学领域:
- 老年学是指老年学的学科.
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 多发病症是一个重大的全球老龄化和公共卫生挑战.
- 现有的多病症患者死亡风险预测模型在质量和临床适用性方面各不相同.
- 不确定性围绕着现有实践模型和未来研究的可靠性.
研究的目的:
- 系统地审查和评估已公布的多病症患者死亡风险预测模型的质量.
- 通过使用标准化工具评估这些模型的偏差风险和适用性.
主要方法:
- 在多个数据库 (PubMed,Embase,Web of Science等) 中进行全面的搜索. 调查时间为2024年5月30日.
- 两个独立的审稿人使用预测模型偏差风险评估工具 (PROBAST) 进行了研究选择,数据提取和质量评估.
主要成果:
- 包括包括21个预测模型的18项研究.
- 后勤回归是最常见的建模技术;年龄和BMI是频繁的预测因素.
- 虽然聚合AUC为0.81 (公平歧视),但三项研究具有低偏差风险,11项研究具有高风险,主要是由于报告问题.
结论:
- 包含的模型显示了在多病性疾病中对死亡率预测的一些歧视能力.
- 然而,所有模型都表现出明显的偏差风险,影响了它们的可靠性.
- 未来的研究必须优先考虑严格的设计和多中心的外部验证,以提高预测的准确性,并为全球卫生战略提供信息.
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