预测儿童外伤性脑损伤颅脑ct后颅内血肿的临床Nomogram外部验证

IF 0.1 Q4 SURGERY
Apisorn Jongjit, Thara Tunthanathip
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引用次数: 0

摘要

摘要:在TBI患儿中观察到头部计算机断层扫描(CT)的过度调查。脑部CT扫描的长期影响已经得到了解决,这些影响应该得到平衡。图是一种简单的预测工具,有文献报道用于预测颅脑损伤儿童头部CT后的颅内损伤。本研究旨在利用未见过的数据验证nomogram的性能。此外,次要目标旨在通过决策曲线分析(DCA)估计nomogram的净效益。方法对64例创伤性脑损伤(TBI)患儿进行回顾性队列研究,并行颅脑CT检查。Nomogram评分根据每位患者的各种变量进行分配;因此,通过实际结果与预测结果的交叉表法估计敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)、准确性和F1评分。此外,将nomogram与使用DCA的“None”和“All”协议的好处进行了比较。结果本研究64例TBI患儿行头部CT检查。交叉表显示,nomogram敏感性为0.60 (95%CI 0.29-0.90),特异性为0.96 (0.91-1.0),PPV值为0.75 (0.44-1.0),NPV值为0.92(0.86-0.99),准确率为0.90 (0.83-0.97),F1评分为0.66(0.59-0.73)。此外,曲线下面积为0.78,定义为可接受的性能。对于0.1高风险阈值的DCA, nomogram净收益为0.75,而“All”方案的净收益为0.40,两者差异明显。结论在一般情况下,nomogram方法是一种适合的替代预测工具,与其他方案相比具有优势。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
External Validation of a Clinical Nomogram for Predicting Intracranial Hematoma Following Head Computed Tomography in Pediatric Traumatic Brain Injury
Abstract Introduction Over-investigation of head computed tomography (CT) has been observed in children with TBI. Long-term effects from a head CT brain scan have been addressed and those should be balanced. A nomogram is a simple prediction tool that has been reported for predicting intracranial injuries following a head CT of the brain in TBI children in literature. This study aims to validate the performance of the nomogram using unseen data. Additionally, the secondary objective aims to estimate the net benefit of the nomogram by decision curve analysis (DCA). Methods We conducted a retrospective cohort study with 64 children who suffered from traumatic brain injury (TBI) and underwent a CT of the brain. Nomogram's scores were assigned according to various variables in each patient; therefore sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and F1 score were estimated by the cross-tabulation of the actual results and the predicted results. Additionally, the benefits of a nomogram were compared with “None” and “All” protocols using DCA. Results There were 64 children with TBI who underwent a head CT in the present study. From the cross-tabulation, the nomogram had a sensitivity of 0.60 (95%CI 0.29–0.90), specificity of 0.96 (0.91–1.0), PPV of 0.75 (0.44–1.0), NPV of 0.92 (0.86–0.99), accuracy of 0.90 (0.83–0.97), and an F1 score of 0.66 (0.59–0.73). Also, the area under the curve was 0.78 which was defined as acceptable performance. For the DCA at 0.1 high-risk threshold, the net benefit of the nomogram was 0.75, whereas the “All” protocol had the net benefit of 0.40 which was obviously different. Conclusion A nomogram is a suitable method as an alternative prediction tool in general practice that has advantages over other protocols.
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CiteScore
0.20
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68
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