在英国生物银行研究中的脆弱参与者中开发和验证死亡率预测模型
Chenkai Wu1, Yanxin Wang1, Junhan Tang1
1Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China.
概括
预测脆弱个体的死亡风险至关重要. 仅调查数据就能有效预测死亡率,而添加生物标志物或物理测量所带来的收益很小,为个性化护理策略提供了信息.
科学领域:
- 老年学与公共卫生
- 生物统计学和流行病学
背景情况:
- 有效的风险评估和预测模型对于管理脆弱人群至关重要.
- 识别脆弱个体的死亡风险需要精确的策略.
- 这项研究使用调查数据,生物标志物和物理测量评估了脆弱个体的预测模型.
研究的目的:
- 评估将调查数据与生物标志物或物理测量相结合的预测模型是否与仅调查模型相比,改善了脆弱个体的死亡风险预测.
- 加强患者管理和精确识别脆弱人群中的死亡风险.
主要方法:
- 利用考克斯模型和光梯度增强机来对15754名英国生物库参与者 (40-72岁) 进行变量选择.
- 评估了所有原因的死亡风险,歧视,校准和重新分类表现.
- 将仅调查模型与包含生物标志物和/或物理测量的模型进行比较.
主要成果:
- 只有调查模型选择了24个男性和19个女性的预测因素,年龄和治疗次数是关键.
- 结合生物标志物或物理测量的模型显示了一些改善,但不是实质性的.
- 基准模型在验证过程中显示出良好的区别 (C统计值0.70-0.78).
结论:
- 基于调查的模型有效预测脆弱个体的死亡率.
- 添加生物标志物或物理测量只能在预测性能方面取得微小的改进.
- 研究结果支持调查对预测结果和脆弱人群个性化管理的有用性.
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