Diagnostic and prognostic research最新文献

{"title":"Quality and transparency of reporting derivation and validation prognostic studies of recurrent stroke in patients with TIA and minor stroke: a systematic review","authors":"K. Abdulaziz, J. Perry, K. Yadav, D. Dowlatshahi, I. Stiell, G. Wells, M. Taljaard","doi":"10.1186/s41512-022-00123-z","DOIUrl":"https://doi.org/10.1186/s41512-022-00123-z","url":null,"abstract":"","PeriodicalId":72800,"journal":{"name":"Diagnostic and prognostic research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42169045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does poor methodological quality of prediction modeling studies translate to poor model performance? An illustration in traumatic brain injury","authors":"I. Helmrich, A. Mikolić, D. Kent, H. Lingsma, L. Wynants, E. Steyerberg, D. van Klaveren","doi":"10.1186/s41512-022-00122-0","DOIUrl":"https://doi.org/10.1186/s41512-022-00122-0","url":null,"abstract":"","PeriodicalId":72800,"journal":{"name":"Diagnostic and prognostic research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49067042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the effect of evaluation sample size on the sensitivity and specificity of COVID-19 diagnostic tests in practice: a simulation study","authors":"C. Sammut-Powell, C. Reynard, Joy A Allen, J. McDermott, Julian Braybrook, R. Parisi, D. Lasserson, R. Body, Richard Gail Joy Julian Peter Paul Kerrie Eloise Adam Anna Body Hayward Allen Braybrook Buckle Dark Davis Coo, R. Body, G. Hayward, Joy A Allen, J. Braybrook, P. Buckle, P. Dark, Kerrie Davis, Eloïse Cook, A. Gordon, Anna Halstead, D. Lasserson, A. Lewington, Brian Nicholson, R. Perera-Salazar, J. Simpson, Philip Turner, Graham Prestwich, C. Reynard, Be Riley, Valerie Tate, Mark A. Wilcox","doi":"10.1186/s41512-021-00116-4","DOIUrl":"https://doi.org/10.1186/s41512-021-00116-4","url":null,"abstract":"","PeriodicalId":72800,"journal":{"name":"Diagnostic and prognostic research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45429790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative prediction error analysis to investigate predictive performance under predictor measurement heterogeneity at model implementation","authors":"K. Luijken, Jiaolei Song, R. Groenwold","doi":"10.1186/s41512-022-00121-1","DOIUrl":"https://doi.org/10.1186/s41512-022-00121-1","url":null,"abstract":"","PeriodicalId":72800,"journal":{"name":"Diagnostic and prognostic research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48348478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multivariable prediction models for health care spending using machine learning: a protocol of a systematic review.","authors":"Andrew W Huang,&nbsp;Martin Haslberger,&nbsp;Neto Coulibaly,&nbsp;Omar Galárraga,&nbsp;Arman Oganisian,&nbsp;Lazaros Belbasis,&nbsp;Orestis A Panagiotou","doi":"10.1186/s41512-022-00119-9","DOIUrl":"https://doi.org/10.1186/s41512-022-00119-9","url":null,"abstract":"<p><strong>Background: </strong>With rising cost pressures on health care systems, machine-learning (ML)-based algorithms are increasingly used to predict health care costs. Despite their potential advantages, the successful implementation of these methods could be undermined by biases introduced in the design, conduct, or analysis of studies seeking to develop and/or validate ML models. The utility of such models may also be negatively affected by poor reporting of these studies. In this systematic review, we aim to evaluate the reporting quality, methodological characteristics, and risk of bias of ML-based prediction models for individual-level health care spending.</p><p><strong>Methods: </strong>We will systematically search PubMed and Embase to identify studies developing, updating, or validating ML-based models to predict an individual's health care spending for any medical condition, over any time period, and in any setting. We will exclude prediction models of aggregate-level health care spending, models used to infer causality, models using radiomics or speech parameters, models of non-clinically validated predictors (e.g., genomics), and cost-effectiveness analyses without predicting individual-level health care spending. We will extract data based on the Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modeling Studies (CHARMS), previously published research, and relevant recommendations. We will assess the adherence of ML-based studies to the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) statement and examine the inclusion of transparency and reproducibility indicators (e.g. statements on data sharing). To assess the risk of bias, we will apply the Prediction model Risk Of Bias Assessment Tool (PROBAST). Findings will be stratified by study design, ML methods used, population characteristics, and medical field.</p><p><strong>Discussion: </strong>Our systematic review will appraise the quality, reporting, and risk of bias of ML-based models for individualized health care cost prediction. This review will provide an overview of the available models and give insights into the strengths and limitations of using ML methods for the prediction of health spending.</p>","PeriodicalId":72800,"journal":{"name":"Diagnostic and prognostic research","volume":" ","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2022-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8943988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40318437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The comparative interrupted time series design for assessment of diagnostic impact: methodological considerations and an example using point-of-care C-reactive protein testing","authors":"T. Fanshawe, P. Turner, Marjorie M. Gillespie, G. Hayward","doi":"10.1186/s41512-022-00118-w","DOIUrl":"https://doi.org/10.1186/s41512-022-00118-w","url":null,"abstract":"","PeriodicalId":72800,"journal":{"name":"Diagnostic and prognostic research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43280795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of methods for predicting COVID-19-related death in the general population using the OpenSAFELY platform.","authors":"Elizabeth J Williamson, John Tazare, Krishnan Bhaskaran, Helen I McDonald, Alex J Walker, Laurie Tomlinson, Kevin Wing, Sebastian Bacon, Chris Bates, Helen J Curtis, Harriet J Forbes, Caroline Minassian, Caroline E Morton, Emily Nightingale, Amir Mehrkar, David Evans, Brian D Nicholson, David A Leon, Peter Inglesby, Brian MacKenna, Nicholas G Davies, Nicholas J DeVito, Henry Drysdale, Jonathan Cockburn, William J Hulme, Jessica Morley, Ian Douglas, Christopher T Rentsch, Rohini Mathur, Angel Wong, Anna Schultze, Richard Croker, John Parry, Frank Hester, Sam Harper, Richard Grieve, David A Harrison, Ewout W Steyerberg, Rosalind M Eggo, Karla Diaz-Ordaz, Ruth Keogh, Stephen J W Evans, Liam Smeeth, Ben Goldacre","doi":"10.1186/s41512-022-00120-2","DOIUrl":"10.1186/s41512-022-00120-2","url":null,"abstract":"<p><strong>Background: </strong>Obtaining accurate estimates of the risk of COVID-19-related death in the general population is challenging in the context of changing levels of circulating infection.</p><p><strong>Methods: </strong>We propose a modelling approach to predict 28-day COVID-19-related death which explicitly accounts for COVID-19 infection prevalence using a series of sub-studies from new landmark times incorporating time-updating proxy measures of COVID-19 infection prevalence. This was compared with an approach ignoring infection prevalence. The target population was adults registered at a general practice in England in March 2020. The outcome was 28-day COVID-19-related death. Predictors included demographic characteristics and comorbidities. Three proxies of local infection prevalence were used: model-based estimates, rate of COVID-19-related attendances in emergency care, and rate of suspected COVID-19 cases in primary care. We used data within the TPP SystmOne electronic health record system linked to Office for National Statistics mortality data, using the OpenSAFELY platform, working on behalf of NHS England. Prediction models were developed in case-cohort samples with a 100-day follow-up. Validation was undertaken in 28-day cohorts from the target population. We considered predictive performance (discrimination and calibration) in geographical and temporal subsets of data not used in developing the risk prediction models. Simple models were contrasted to models including a full range of predictors.</p><p><strong>Results: </strong>Prediction models were developed on 11,972,947 individuals, of whom 7999 experienced COVID-19-related death. All models discriminated well between individuals who did and did not experience the outcome, including simple models adjusting only for basic demographics and number of comorbidities: C-statistics 0.92-0.94. However, absolute risk estimates were substantially miscalibrated when infection prevalence was not explicitly modelled.</p><p><strong>Conclusions: </strong>Our proposed models allow absolute risk estimation in the context of changing infection prevalence but predictive performance is sensitive to the proxy for infection prevalence. Simple models can provide excellent discrimination and may simplify implementation of risk prediction tools.</p>","PeriodicalId":72800,"journal":{"name":"Diagnostic and prognostic research","volume":"6 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2022-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8865947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9149943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosing ventilator-associated pneumonia (VAP) in UK NHS ICUs: the perceived value and role of a novel optical technology.","authors":"W S Jones,&nbsp;J Suklan,&nbsp;A Winter,&nbsp;K Green,&nbsp;T Craven,&nbsp;A Bruce,&nbsp;J Mair,&nbsp;K Dhaliwal,&nbsp;T Walsh,&nbsp;A J Simpson,&nbsp;S Graziadio,&nbsp;A J Allen","doi":"10.1186/s41512-022-00117-x","DOIUrl":"https://doi.org/10.1186/s41512-022-00117-x","url":null,"abstract":"<p><strong>Background: </strong>Diagnosing ventilator-associated pneumonia (VAP) in an intensive care unit (ICU) is a complex process. Our aim was to collect, evaluate and represent the information relating to current clinical practice for the diagnosis of VAP in UK NHS ICUs, and to explore the potential value and role of a novel diagnostic for VAP, which uses optical molecular alveoscopy to visualise the alveolar space.</p><p><strong>Methods: </strong>Qualitative study performing semi-structured interviews with clinical experts. Interviews were recorded, transcribed, and thematically analysed. A flow diagram of the VAP patient pathway was elicited and validated with the expert interviewees. Fourteen clinicians were interviewed from a range of UK NHS hospitals: 12 ICU consultants, 1 professor of respiratory medicine and 1 professor of critical care.</p><p><strong>Results: </strong>Five themes were identified, relating to [1] current practice for the diagnosis of VAP, [2] current clinical need in VAP diagnostics, [3] the potential value and role of the technology, [4] the barriers to adoption and [5] the evidence requirements for the technology, to help facilitate a successful adoption. These themes indicated that diagnosis of VAP is extremely difficult, as is the decision to stop antibiotic treatment. The analysis revealed that there is a clinical need for a diagnostic that provides an accurate and timely diagnosis of the causative pathogen, without the long delays associated with return of culture results, and which is not dangerous to the patient. It was determined that the technology would satisfy important aspects of this clinical need for diagnosing VAP (and pneumonia, more generally), but would require further evidence on safety and efficacy in the patient population to facilitate adoption.</p><p><strong>Conclusions: </strong>Care pathway analysis performed in this study was deemed accurate and representative of current practice for diagnosing VAP in a UK ICU as determined by relevant clinical experts, and explored the value and role of a novel diagnostic, which uses optical technology, and could streamline the diagnostic pathway for VAP and other pneumonias.</p>","PeriodicalId":72800,"journal":{"name":"Diagnostic and prognostic research","volume":" ","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2022-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8830125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39612870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Graphical calibration curves and the integrated calibration index (ICI) for competing risk models.","authors":"Peter C Austin,&nbsp;Hein Putter,&nbsp;Daniele Giardiello,&nbsp;David van Klaveren","doi":"10.1186/s41512-021-00114-6","DOIUrl":"https://doi.org/10.1186/s41512-021-00114-6","url":null,"abstract":"<p><strong>Background: </strong>Assessing calibration-the agreement between estimated risk and observed proportions-is an important component of deriving and validating clinical prediction models. Methods for assessing the calibration of prognostic models for use with competing risk data have received little attention.</p><p><strong>Methods: </strong>We propose a method for graphically assessing the calibration of competing risk regression models. Our proposed method can be used to assess the calibration of any model for estimating incidence in the presence of competing risk (e.g., a Fine-Gray subdistribution hazard model; a combination of cause-specific hazard functions; or a random survival forest). Our method is based on using the Fine-Gray subdistribution hazard model to regress the cumulative incidence function of the cause-specific outcome of interest on the predicted outcome risk of the model whose calibration we want to assess. We provide modifications of the integrated calibration index (ICI), of E50 and of E90, which are numerical calibration metrics, for use with competing risk data. We conducted a series of Monte Carlo simulations to evaluate the performance of these calibration measures when the underlying model has been correctly specified and when the model was mis-specified and when the incidence of the cause-specific outcome differed between the derivation and validation samples. We illustrated the usefulness of calibration curves and the numerical calibration metrics by comparing the calibration of a Fine-Gray subdistribution hazards regression model with that of random survival forests for predicting cardiovascular mortality in patients hospitalized with heart failure.</p><p><strong>Results: </strong>The simulations indicated that the method for constructing graphical calibration curves and the associated calibration metrics performed as desired. We also demonstrated that the numerical calibration metrics can be used as optimization criteria when tuning machine learning methods for competing risk outcomes.</p><p><strong>Conclusions: </strong>The calibration curves and numeric calibration metrics permit a comprehensive comparison of the calibration of different competing risk models.</p>","PeriodicalId":72800,"journal":{"name":"Diagnostic and prognostic research","volume":" ","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2022-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8762819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39828527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of binary prediction models in high-correlation low-dimensional settings: a comparison of methods.","authors":"Artuur M Leeuwenberg,&nbsp;Maarten van Smeden,&nbsp;Johannes A Langendijk,&nbsp;Arjen van der Schaaf,&nbsp;Murielle E Mauer,&nbsp;Karel G M Moons,&nbsp;Johannes B Reitsma,&nbsp;Ewoud Schuit","doi":"10.1186/s41512-021-00115-5","DOIUrl":"https://doi.org/10.1186/s41512-021-00115-5","url":null,"abstract":"<p><strong>Background: </strong>Clinical prediction models are developed widely across medical disciplines. When predictors in such models are highly collinear, unexpected or spurious predictor-outcome associations may occur, thereby potentially reducing face-validity of the prediction model. Collinearity can be dealt with by exclusion of collinear predictors, but when there is no a priori motivation (besides collinearity) to include or exclude specific predictors, such an approach is arbitrary and possibly inappropriate.</p><p><strong>Methods: </strong>We compare different methods to address collinearity, including shrinkage, dimensionality reduction, and constrained optimization. The effectiveness of these methods is illustrated via simulations.</p><p><strong>Results: </strong>In the conducted simulations, no effect of collinearity was observed on predictive outcomes (AUC, R², Intercept, Slope) across methods. However, a negative effect of collinearity on the stability of predictor selection was found, affecting all compared methods, but in particular methods that perform strong predictor selection (e.g., Lasso). Methods for which the included set of predictors remained most stable under increased collinearity were Ridge, PCLR, LAELR, and Dropout.</p><p><strong>Conclusions: </strong>Based on the results, we would recommend refraining from data-driven predictor selection approaches in the presence of high collinearity, because of the increased instability of predictor selection, even in relatively high events-per-variable settings. The selection of certain predictors over others may disproportionally give the impression that included predictors have a stronger association with the outcome than excluded predictors.</p>","PeriodicalId":72800,"journal":{"name":"Diagnostic and prognostic research","volume":" ","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2022-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8751246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39900592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}