临床预测模型的外部验证,影响评估和临床利用:一个前性队列研究
Banafsheh Arshi1, Laura Elizabeth Cowley2, Eline Rijnhart3
1Faculty of Health, Medicine and Life Sciences, Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands; Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands.
Journal of clinical epidemiology
|July 17, 2025
概括
很少有临床预测模型 (CPM) 在开发后经过外部验证或影响评估,尽管有些在实践中使用. 加强验证和评估对于患者安全至关重要.
科学领域:
- 临床预测模型的临床预测模型.
- 医疗服务研究 医疗服务研究
- 医疗信息学医学信息学
背景情况:
- 临床预测模型 (CPM) 是为了帮助临床决策而开发的.
- 包括验证和利用在内的CPM开发后的发展轨迹尚不清楚.
研究的目的:
- 量化CPM在最初开发后的外部验证,影响评估和临床实践利用程度.
主要方法:
- 对109篇基于回归的CPM开发文章 (1995-2020) 进行了前引文搜索.
- 卡普兰-梅尔分析估计了验证和影响评估的概率.
- 一项调查评估了开发的CPM的临床利用情况.
主要成果:
- 只有17%的CPM开发文章报告了外部验证.
- 五年和十年的验证概率分别为13%和16%.
- 发表的影响评估很少 (10年概率:1%),在实践中使用的模型中,只有24%得到了外部验证.
结论:
- 对CPM的外部验证和影响评估并不常见,即使对于临床环境中使用的模型也是如此.
- 缺乏严格的验证和评估对患者安全构成风险.
- 对于可靠的CPM来说,需要更加重视外部验证和影响评估.
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