从医院管理数据库中开发的地诺单抗诱发低钙血症风险预测模型的外部验证和更新。

IF 3.3 Q2 ONCOLOGY JCO Clinical Cancer Informatics Pub Date : 2024-07-01 DOI:10.1200/CCI.24.00078
Keisuke Ikegami, Shungo Imai, Osamu Yasumuro, Masami Tsuchiya, Naomi Henmi, Mariko Suzuki, Katsuhisa Hayashi, Chisato Miura, Haruna Abe, Hayato Kizaki, Ryohkan Funakoshi, Yasunori Sato, Satoko Hori
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引用次数: 0

摘要

目的:地诺单抗用于治疗实体瘤骨转移患者,但有时会导致严重的低钙血症,因此谨慎的临床管理非常重要。本研究旨在利用日本两家具有不同特点的医疗机构的数据,对我们之前开发的地诺单抗诱发低钙血症的风险预测模型进行外部验证,并开发出性能更佳、更具普遍性的最新模型:在外部验证中,使用了龟田综合医院(KGH)和宫城癌症中心(MCC)2013年6月至2022年6月期间的回顾性数据,并主要评估了接收器操作特征(ROC)-AUC。使用与之前相同的医院行政数据库数据集,开发了基于评分的更新模型。与低钙血症预测相关的变量的选择基于外部验证的结果:外部验证收集了235名KGH患者和224名MCC患者的数据。原始模型的ROC-AUC值分别为0.879和0.774。由临床实验室检测(钙、白蛋白和碱性磷酸酶)组成的更新模型在两家医院的ROC-AUC值相似(KGH,0.837;MCC,0.856):我们建立了一个更新的地诺单抗诱发低钙血症的风险预测模型,但两家医院之间的差异很小。我们的研究结果表明,在对通用预测模型进行外部验证时,使用来自具有不同特征的多个机构的数据非常重要,而且可能与风险预测模型的临床应用具有普遍相关性。我们的研究结果有望为改善骨转移治疗管理做出贡献。
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External Validation and Update of the Risk Prediction Model for Denosumab-Induced Hypocalcemia Developed From a Hospital-Based Administrative Database.

Purpose: Denosumab is used to treat patients with bone metastasis from solid tumors, but sometimes causes severe hypocalcemia, so careful clinical management is important. This study aims to externally validate our previously developed risk prediction model for denosumab-induced hypocalcemia by using data from two facilities with different characteristics in Japan and to develop an updated model with improved performance and generalizability.

Methods: In the external validation, retrospective data of Kameda General Hospital (KGH) and Miyagi Cancer Center (MCC) between June 2013 and June 2022 were used and receiver operating characteristic (ROC)-AUC was mainly evaluated. A scoring-based updated model was developed using the same data set from a hospital-based administrative database as previously employed. Selection of variables related to prediction of hypocalcemia was based on the results of external validation.

Results: For the external validation, data from 235 KGH patients and 224 MCC patients were collected. ROC-AUC values in the original model were 0.879 and 0.774, respectively. The updated model consisting of clinical laboratory tests (calcium, albumin, and alkaline phosphatase) afforded similar ROC-AUC values in the two facilities (KGH, 0.837; MCC, 0.856).

Conclusion: We developed an updated risk prediction model for denosumab-induced hypocalcemia with small interfacility differences. Our results indicate the importance of using data from plural facilities with different characteristics in the external validation of generalized prediction models and may be generally relevant to the clinical application of risk prediction models. Our findings are expected to contribute to improved management of bone metastasis treatment.

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