在患有良性甲状腺结节的患者中对甲状腺功能障碍的预测建模:使用Vizient数据库的队列研究
Christopher S Hollenbeak1, Qiang Hao1, Melody Greer2
1Department of Health Policy and Administration, College of Health and Human Development, The Pennsylvania State University, Pennsylvania, USA.
Head & neck
|July 12, 2025
概括
预测模型可以在患有良性甲状腺结节的患者中识别原发性甲状腺功能障碍症 (pHPT),帮助早期诊断. 机器学习模型在预测pHPT时显示了与后勤回归相似的性能.
科学领域:
- 内分泌学 在内分泌学.
- 医疗信息学 医疗信息学
- 预测分析是一种预测分析.
背景情况:
- 初级甲状腺功能障碍症 (pHPT) 是高血症的主要原因,很大一部分病例仍未被诊断出来.
- 早期诊断和治疗pHPT对于管理高血症及其相关并发症至关重要.
研究的目的:
- 评估使用大型临床数据库的预测建模的有效性,以确定患有良性甲状腺结节的患者的pHPT.
- 为了比较物流回归的性能与机器学习算法用于pHPT预测.
主要方法:
- 来自1000多家医院的Vizient临床数据库 (CDB) 的回顾性分析 (2020-2023年).
- 开发一个用于pHPT的预测模型,使用逻辑回归和与高斯素朴贝叶斯,随机梯度下降和基于直方图的梯度增强分类器进行比较.
- 对人口统计,并发症和药物使用进行控制分析;通过ICD-10代码测量结果;通过ROC曲线分析评估模型性能.
主要成果:
- 基底图梯度增强模型实现了ROC曲线下的面积为68.7%,略高于后勤回归 (68.1%).
- 在所有模型中,分类准确度很高,后勤回归,梯度下降和直方图梯度增强分别实现了80.4%和80.5%的正确分类.
- 在5%的门下进行后勤回归,pHPT检测的灵敏度为38.5%,特异性为81.8%.
结论:
- 使用大型临床数据集,预测建模可用于识别患有良性甲状腺结节的患者的pHPT.
- 开发的预测模型,特别是机器学习算法,有可能被整合到临床决策支持系统中.
- 提醒临床医生潜在的未被诊断的pHPT可以促进及时诊断和治疗,改善患者的治疗结果.
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