Xin'ang Jiang, Jun Hu, Qinling Jiang, Taohu Zhou, Fei Yao, Yi Sun, Chao Zhou, Qianyun Ma, Jingyi Zhao, Kang Shi, Wen Yang, Xiuxiu Zhou, Yun Wang, Shiyuan Liu, Xiaoyan Xin, Li Fan
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引用次数: 0
Abstract
Background: COVID-19 remains widespread and poses a threat to people's physical and mental health, especially middle-aged and elderly individuals. Early identification of COVID-19 patients at high risk of progressing to critical disease helps improve overall patient outcomes and healthcare efficiency.
Purpose: To develop a radiomics nomogram to predict the risk of newly admitted middle-aged and elderly COVID-19 patients progressing to critical disease.
Methods: A total of 794 patients (aged 40 years or above) were retrospectively included in the study from two institutions, all of them were with non-critical COVID-19 on admission. At follow-up, patients were divided into non-critical group and critical group. About 443 patients (384 non-critical and 59 critical) from the first hospital were randomly assigned to the training (n = 311) and internal validation (n = 132) set in a 7:3 ratio. Additionally, an independent external cohort of 351 patients (292 non-critical and 59 critical) from another hospital was evaluated. Radiomics signatures and clinical indicators were used to build a radiomics model and a clinical model after computed tomography (CT) image processing, CT whole-lung segmentation, feature extraction, and feature selection. The radiomics nomogram model integrated radiomics model and clinical model. The receiver operating characteristic curve (AUC) was used to assess the performance of the proposed models. Calibration curves and decision curve analysis were used to assess the performance of the radiomics nomogram.
Results: For the training, internal validation, and external validation sets, the AUC values of the radiomic nomogram for the prediction of COVID-19 progression were 0.916, 0.917, and 0.890, respectively. Calibration curves indicated that there was no significant departure between prediction and observation in three sets. The decision curve image demonstrated the clinical utility of the nomogram model.
Conclusions: Our nomogram model incorporates radiomics features and clinical indicators, it provides a new pathway to increase predictive accuracy or clinical utility, further helping to provide personalized management for middle-aged and elderly patients with COVID-19.
期刊介绍:
Journal of Applied Clinical Medical Physics is an international Open Access publication dedicated to clinical medical physics. JACMP welcomes original contributions dealing with all aspects of medical physics from scientists working in the clinical medical physics around the world. JACMP accepts only online submission.
JACMP will publish:
-Original Contributions: Peer-reviewed, investigations that represent new and significant contributions to the field. Recommended word count: up to 7500.
-Review Articles: Reviews of major areas or sub-areas in the field of clinical medical physics. These articles may be of any length and are peer reviewed.
-Technical Notes: These should be no longer than 3000 words, including key references.
-Letters to the Editor: Comments on papers published in JACMP or on any other matters of interest to clinical medical physics. These should not be more than 1250 (including the literature) and their publication is only based on the decision of the editor, who occasionally asks experts on the merit of the contents.
-Book Reviews: The editorial office solicits Book Reviews.
-Announcements of Forthcoming Meetings: The Editor may provide notice of forthcoming meetings, course offerings, and other events relevant to clinical medical physics.
-Parallel Opposed Editorial: We welcome topics relevant to clinical practice and medical physics profession. The contents can be controversial debate or opposed aspects of an issue. One author argues for the position and the other against. Each side of the debate contains an opening statement up to 800 words, followed by a rebuttal up to 500 words. Readers interested in participating in this series should contact the moderator with a proposed title and a short description of the topic