全髋关节置换术患者的临床预测模型:基于系统综述和荷兰关节置换术登记册的外部验证。

IF 2.5 2区 医学 Q1 ORTHOPEDICS Acta Orthopaedica Pub Date : 2024-11-25 DOI:10.2340/17453674.2024.42449
Maartje Belt, Katrijn Smulders, B Willem Schreurs, Gerjon Hannink
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引用次数: 0

摘要

背景和目的:外部验证是预测模型开发后的一个关键步骤。尽管人们对预测模型的兴趣与日俱增,但外部验证却经常被忽视。我们旨在评估是否可以利用关节登记处对预测模型进行外部验证,以及已发表的预测模型是否适用于接受全髋关节置换术的荷兰人群: 我们通过系统性文献检索确定了针对接受关节置换术的患者开发的预测模型。我们评估了荷兰关节置换术登记处(LROI)中模型变量的可用性。我们从校准和区分度(曲线下面积 [AUC])方面评估了模型的性能。此外,我们还通过截距重新校准和逻辑重新校准对模型进行了更新和评估: 在对 54 篇论文进行评估后,有 19 篇论文因未描述预测模型(16 篇)或关注非 TJA 群体(3 篇)而被排除,剩下的 35 篇论文描述了 44 个预测模型。90%(40/44)的预测模型使用了 LROI 中缺失的结果或预测因子,如糖尿病、阿片类药物使用和抑郁症。有 4 个模型可以通过 LROI 数据进行外部验证。这些模型的辨别能力介于较差和可接受之间,与开发队列中的模型相似。模型的校准不够充分。更新后,模型的性能略有提高: 对 4 个模型进行外部验证的结果是,在荷兰人群中的预测性能并不理想,这凸显了外部验证研究的重要性。
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Clinical prediction models for patients undergoing total hip arthroplasty: an external validation based on a systematic review and the Dutch Arthroplasty Register.

Background and purpose:  External validation is a crucial step after prediction model development. Despite increasing interest in prediction models, external validation is frequently overlooked. We aimed to evaluate whether joint registries can be utilized for external validation of prediction models, and whether published prediction models are valid for the Dutch population with a total hip arthroplasty.

Methods:  We identified prediction models developed in patients undergoing arthroplasty through a systematic literature search. Model variables were evaluated for availability in the Dutch Arthroplasty Registry (LROI). We assessed the model performance in terms of calibration and discrimination (area under the curve [AUC]). Furthermore, the models were updated and evaluated through intercept recalibration and logistic recalibration.

Results:  After assessing 54 papers, 19 were excluded for not describing a prediction model (n = 16) or focusing on non-TJA populations (n = 3), leaving 35 papers describing 44 prediction models. 90% (40/44) of the prediction models used outcomes or predictors missing in the LROI, such as diabetes, opioid use, and depression. 4 models could be externally validated on LROI data. The models' discrimination ranged between poor and acceptable and was similar to that in the development cohort. The calibration of the models was insufficient. The model performance improved slightly after updating.

Conclusion:  External validation of the 4 models resulted in suboptimal predictive performance in the Dutch population, highlighting the importance of external validation studies.

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来源期刊
Acta Orthopaedica
Acta Orthopaedica 医学-整形外科
CiteScore
6.40
自引率
8.10%
发文量
105
审稿时长
4-8 weeks
期刊介绍: Acta Orthopaedica (previously Acta Orthopaedica Scandinavica) presents original articles of basic research interest, as well as clinical studies in the field of orthopedics and related sub disciplines. Ever since the journal was founded in 1930, by a group of Scandinavian orthopedic surgeons, the journal has been published for an international audience. Acta Orthopaedica is owned by the Nordic Orthopaedic Federation and is the official publication of this federation.
期刊最新文献
Radiostereometric measurement of implant migration in robotically assisted vs conventional bi-cruciate stabilized cemented total knee arthroplasty: secondary analysis of a randomized controlled trial. Antibiotic prophylaxis and incidence of infection following elbow arthroplasty: a nationwide study. Fractures sustained by slipping on ice or snow: an epidemiological study of 50,500 fractures from the Swedish Fracture Register. Day-case hip and knee arthroplasty does not increase healthcare system contacts: a prospective multicenter study in a public healthcare setting. Time trends in spine surgery in Italy: a nationwide, population-based study of 1,560,969 records of administrative health data from 2001 to 2019.
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