用于预测外围动脉疾病的诊断模型:系统审查和元分析
Xiaoyan Quan1,2, Huarong Xiong3, Xiaoyu Liu2
1Department of Nursing, The Affiliated Hospital, Southwest Medical University, Luzhou, China.
Scientific reports
|July 22, 2025
概括
外周动脉疾病 (PAD) 预测模型表现良好,但往往具有很高的偏差. 未来的研究需要改进方法,以更好地用于诊断PAD的临床使用.
科学领域:
- 医疗信息学 医疗信息学
- 流行病学 流行病学
- 生物统计学 生物统计学
背景情况:
- 周围动脉疾病 (PAD) 影响全球超过2.36亿人,增加肢体事件和死亡的风险.
- 存在许多PAD诊断预测模型,但它们的质量和临床适用性是不一致的.
- 对这些模型的方法严格性进行系统评估对于可靠的临床决策至关重要.
研究的目的:
- 系统地评估PAD诊断预测模型的开发或验证研究中的方法质量和偏差风险.
- 评估现有的PAD诊断预测模型的整体性能.
- 确定在PAD预测模型的设计和应用中需要改进的领域.
主要方法:
- 在PubMed,Embase,Web of Science和Cochrane图书馆进行了全面的文献搜索,截至2025年6月1日.
- 来自24项符合条件的PAD诊断预测模型研究的数据被两个研究人员独立选和提取.
- 预测模型偏差风险评估工具 (PROBAST) 用于评估包含的研究中的偏差风险.
主要成果:
- 大多数包括在内的24项研究都表现出高偏差风险,特别是在研究人群和统计分析方面.
- 接受器运行特征曲线 (AUC) 下的元分析面积为0.79,表明有利的预测性能.
- 通常报告的预测因素包括年龄,性别,高血压,糖尿病,吸烟和BMI,模型使用2到20个变量.
结论:
- PAD诊断预测模型显示出良好的预测性能,但存在显著的方法限制和异质性.
- 在模型设计,构建,评估和验证方面的改进对于改善临床实用性至关重要.
- 未来的努力应集中在多中心外部验证和透明报告上,以促进在临床实践中采用PAD预测模型.
相关概念视频
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
36
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
36
01:26Peripheral Artery Disease IV: Nursing Management
46
The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
46
01:30Peripheral Artery Disease I: Introduction
34
Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
34
01:27Peripheral Artery Disease III: Interprofessional Care
30
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
30
01:27Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
40
Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
40
01:23Peripheral Artery Disease V: Postoperative Nursing Management
26
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
26