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外部验证的痴呆风险预测模型的歧视性表现:系统性审查和元分析
Blossom C M Stephan1, Jacob Brain2,3, Kaarin J Anstey4,5,6
1Dementia Centre of Excellence, Curtin enAble Institute, Curtin University, Perth, WA, Australia.
BMC medicine
|February 3, 2026
概括
这一系统性审查发现,几种痴呆风险预测模型显示出良好的外部有效性. 该BDSI模型在不同环境和痴呆症类型中显示出有希望的概括性.
科学领域:
- 流行病学 流行病学
- 老年学是一门学科.
- 生物统计学 生物统计学
背景情况:
- 缺乏对痴呆风险预测模型的外部验证数据的系统综合.
- 之前的审查没有全面评估基于人口的环境中的模型性能.
研究的目的:
- 系统地审查和元分析痴呆风险预测模型的外部验证结果.
- 评估这些模型在基于人口的队列中的预测歧视性表现.
主要方法:
- 在Embase,Medline,Scopus和Web of Science进行了搜索,截至2024年11月.
- 包括基于人群的队列研究,评估发生的晚年痴呆症 (≥60岁).
- 提取了模型验证类型 (完全或部分) 和区分性性能 (AUC/c-统计) 的数据,使用随机效应模型汇集了结果.
主要成果:
- 包括36项研究,其中17项对14个独特模型进行了完全验证.
- RADaR (c-统计=0.83) 和eRADAR (c-统计=0.81) 在所有原因的痴呆症中表现最好.
- 该BDSI模型得到了最多的验证 (所有原因痴呆症c-统计=0.72) 并在收入水平上表现一致.
结论:
- 几种痴呆风险预测模型具有中等到高的外部有效性.
- BDSI模型显示出有希望的通用性.
- 在临床广泛采用之前,需要进一步研究可行性和成本效益,特别是在低收入国家.
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