基于机器学习的糖尿病肺部感染个性化预测模型构建

IF 2.4 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Qian Shen
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引用次数: 0

摘要

目的:本研究旨在建立并验证一种基于临床特征的nomogram预测糖尿病患者肺部感染风险的方法。方法:回顾性纳入我院诊断为肺部感染的168例患者(包括糖尿病和非糖尿病患者),并将其分为训练队列和内部验证队列。采用最小绝对收缩和选择算子(LASSO)方法进行特征选择,然后进行多元逻辑回归分析,构建预测模态图。通过校准曲线、受试者工作特征(ROC)分析和决策曲线分析(DCA)评估模型的性能,分别评估预测准确性、校准和临床实用性。结果:多因素分析发现,高龄、男性、中性粒细胞计数异常、糖化血红蛋白(HbA1c)升高和空腹血糖(FPG)水平是糖尿病肺部感染的独立危险因素。结合这些变量和其他临床相关预测因子构建了一个nomogram。训练集的ROC曲线下面积(AUC)为0.919 (95%CI: 0.825-0.937),验证集的AUC为0.862 (95%CI: 0.819-0.912),判别能力较强。校正曲线显示预测结果与观测结果吻合良好。DCA在广泛的阈值概率范围内证实了nomogram临床价值。结论:我们开发了一种可靠且临床适用的nomogram预测糖尿病合并肺部感染患者发生肺炎的风险。该模型具有很高的准确性,可以帮助临床医生识别高危人群,这些人可以从早期预防措施和及时干预中受益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Construction of a Personalized Prediction Model for Diabetic Lung Infection Based on Machine Learning.

Objective: This study aimed to develop and validate a clinical feature-based nomogram to predict the risk of lung infection in diabetic patients.

Methods: A total of 168 patients diagnosed with pulmonary infections at our hospital-comprising both diabetic and Nondiabetic individuals-were retrospectively enrolled and divided into a training cohort and an internal validation cohort. Feature selection was performed using the least absolute shrinkage and selection operator (LASSO) method, followed by multivariate logistic regression analysis to construct the predictive nomogram. Model performance was evaluated through calibration curves, receiver operating characteristic (ROC) analysis, and decision curve analysis (DCA) to assess predictive accuracy, calibration, and clinical utility, respectively.

Results: Multivariate analysis identified advanced age, male sex, abnormal neutrophil count, elevated glycated hemoglobin (HbA1c), and fasting plasma glucose (FPG) levels as independent risk factors for diabetic lung infection. A nomogram incorporating these variables and other clinically relevant predictors was constructed. The area under the ROC curve (AUC) was 0.919 (95%CI: 0.825-0.937) in the training set and 0.862 (95% CI: 0.819-0.912) in the validation set, indicating strong discriminative ability. Calibration curves demonstrated good agreement between predicted and observed outcomes. DCA confirmed the nomogram's clinical value across a wide range of threshold probabilities.

Conclusion: We developed a robust and clinically applicable nomogram for predicting the risk of pneumonia in diabetic patients with pulmonary infections. This model exhibits high accuracy and may assist clinicians in identifying high-risk individuals who could benefit from early preventive measures and timely interventions.

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来源期刊
Clinical Endocrinology
Clinical Endocrinology 医学-内分泌学与代谢
CiteScore
6.40
自引率
3.10%
发文量
192
审稿时长
1 months
期刊介绍: Clinical Endocrinology publishes papers and reviews which focus on the clinical aspects of endocrinology, including the clinical application of molecular endocrinology. It does not publish papers relating directly to diabetes care and clinical management. It features reviews, original papers, commentaries, correspondence and Clinical Questions. Clinical Endocrinology is essential reading not only for those engaged in endocrinological research but also for those involved primarily in clinical practice.
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