预测多发性硬化症患者随后临床遇到的自杀念头
Farren Bs Briggs1, Isabella Genuario2, Alessandro S De Nadai3
1Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
Multiple sclerosis (Houndmills, Basingstoke, England)
|August 25, 2025
概括
自杀念头 (SI) 影响了30%的多发性硬化症患者. 研究人员使用电子健康记录和自我报告数据开发了预测模型,以识别面临风险的个人进行主动护理.
科学领域:
- 神经学
- 精神病学
- 卫生信息学
背景情况:
- 患有多发性硬化症的人一生有30%的自杀念头.
- 目前还没有有效的预测工具来识别SI风险的PwMS.
- 这种差距需要开发早期风险检测方法.
研究的目的:
- 开发和验证多发性硬化症患者自杀念头 (SI) 的预测模型.
- 利用低负担的自我报告措施和电子健康记录 (EHR) 数据进行模型开发.
- 为将SI风险预测纳入常规临床实践创建可访问的工具.
主要方法:
- 使用了回顾性队列研究设计,分析了5694个PwMS的数据.
- 使用最小绝对收缩和选择运算符 (LASSO) 和关联测试构建了预测模型.
- 为各种子组开发模型,包括性别特定和诊断特定的队列,并进行内部验证.
主要成果:
- 在5694个PwMS中,578个在随访时报告了SI.
- 确定的主要预测因素包括PHQ-9第6项 (无价感) 和临床接触之间的时间.
- 开发的模型具有很高的预测准确性,曲线下的面积 (AUC) 从0.73到0.77不等.
结论:
- 创建了Nomograms和一个在线应用程序,以促进在PwMS中主动预测SI风险.
- 这些工具提供了一个整合SI风险评估到常规护理的框架.
- 建议进行进一步的样本外交叉验证,以确认模型的稳定性.
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