开发和验证用于预测脑瘫儿童智力残疾的提名图

IF 5.3 1区 心理学 Q1 PSYCHOLOGY, CLINICAL International Journal of Clinical and Health Psychology Pub Date : 2024-07-01 DOI:10.1016/j.ijchp.2024.100493
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引用次数: 0

摘要

目的智力障碍(ID)是脑瘫(CP)儿童的一种普遍合并症,给个人、家庭和社会带来了巨大挑战。本研究旨在建立一个预测模型,以评估 CP 儿童患 ID 的风险。方法我们分析了 885 名确诊为 CP 的儿童的数据,其中 377 名儿童患有 ID。我们使用最小绝对缩减和选择算子回归,以及单变量和多变量逻辑回归,确定了 ID 的关键预测因素。通过接收者操作特征曲线、校准图和决策曲线分析(DCA)对模型的性能进行了评估。结果预测提名图包括早产、CP 亚型、粗大运动功能分类系统水平、MRI 分类类别、癫痫状态和听力损失等变量。该模型具有很强的区分度,接收者操作特征曲线下面积(AUC)为 0.781(95% CI:0.7504-0.8116),自引导 AUC 为 0.7624(95% CI:0.7216-0.8032)。校准图和 Hosmer-Lemeshow 检验表明拟合度良好(χ2= 7.9061,p = 0.4427)。DCA证实了该模型的临床实用性。将病例按 7:3 的比例随机分为测试组和验证组,结果表明该模型具有很强的区分度、良好的拟合度和临床实用性;按性别进行分层时,结果也类似。分层风险类别为临床管理提供了精确的指导,旨在通过利用幼儿期的神经可塑性,优化脊髓灰质炎患儿的预后。
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Development and validation of a nomogram for predicting intellectual disability in children with cerebral palsy

Objective

Intellectual disability (ID) is a prevalent comorbidity in children with cerebral palsy (CP), presenting significant challenges to individuals, families and society. This study aims to develop a predictive model to assess the risk of ID in children with CP.

Methods

We analyzed data from 885 children diagnosed with CP, among whom 377 had ID. Using least absolute shrinkage and selection operator regression, along with univariate and multivariate logistic regression, we identified key predictors for ID. Model performance was evaluated through receiver operating characteristic curves, calibration plots, and decision curve analysis (DCA). Bootstrapping validation was also employed.

Results

The predictive nomogram included variables such as preterm birth, CP subtypes, Gross Motor Function Classification System level, MRI classification category, epilepsy status and hearing loss. The model demonstrated strong discrimination with an area under the receiver operating characteristic curve (AUC) of 0.781 (95% CI: 0.7504-0.8116) and a bootstrapped AUC of 0.7624 (95% CI: 0.7216-0.8032). Calibration plots and the Hosmer-Lemeshow test indicated a good fit (χ2= 7.9061, p = 0.4427). DCA confirmed the model's clinical utility. The cases were randomly divided into test group and validation group at a 7:3 ratio, demonstrating strong discrimination, good fit and clinical utility; similar results were found when stratified by sex.

Conclusions

This predictive model effectively identifies children with CP at a high risk for ID, facilitating early intervention strategies. Stratified risk categories provide precise guidance for clinical management, aiming to optimize outcomes for children with CP by leveraging neuroplasticity during early childhood.

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来源期刊
CiteScore
10.70
自引率
5.70%
发文量
38
审稿时长
33 days
期刊介绍: The International Journal of Clinical and Health Psychology is dedicated to publishing manuscripts with a strong emphasis on both basic and applied research, encompassing experimental, clinical, and theoretical contributions that advance the fields of Clinical and Health Psychology. With a focus on four core domains—clinical psychology and psychotherapy, psychopathology, health psychology, and clinical neurosciences—the IJCHP seeks to provide a comprehensive platform for scholarly discourse and innovation. The journal accepts Original Articles (empirical studies) and Review Articles. Manuscripts submitted to IJCHP should be original and not previously published or under consideration elsewhere. All signing authors must unanimously agree on the submitted version of the manuscript. By submitting their work, authors agree to transfer their copyrights to the Journal for the duration of the editorial process.
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