Liou T G, Adler F R, Fitzsimmons S C, Cahill B C, Hibbs J R, Marshall B C
Department of Internal Medicine, Health Sciences Center, University of Utah, Salt Lake City 84132, USA.
Am J Epidemiol. 2001 Feb 15;153(4):345-52. doi: 10.1093/aje/153.4.345.
The objective of this study was to create a 5-year survivorship model to identify key clinical features of cystic fibrosis. Such a model could help researchers and clinicians to evaluate therapies, improve the design of prospective studies, monitor practice patterns, counsel individual patients, and determine the best candidates for lung transplantation. The authors used information from the Cystic Fibrosis Foundation Patient Registry (CFFPR), which has collected longitudinal data on approximately 90% of cystic fibrosis patients diagnosed in the United States since 1986. They developed multivariate logistic regression models by using data on 5,820 patients randomly selected from 11,630 in the CFFPR in 1993. Models were tested for goodness of fit and were validated for the remaining 5,810 patients for 1993. The validated 5-year survivorship model included age, forced expiratory volume in 1 second as a percentage of predicted normal, gender, weight-for-age z score, pancreatic sufficiency, diabetes mellitus, Staphylococcus aureus infection, Burkerholderia cepacia infection, and annual number of acute pulmonary exacerbations. The model provides insights into the complex nature of cystic fibrosis and supplies a rigorous tool for clinical practice and research.
本研究的目的是创建一个5年生存模型,以识别囊性纤维化的关键临床特征。这样一个模型可以帮助研究人员和临床医生评估治疗方法,改进前瞻性研究的设计,监测实践模式,为个体患者提供咨询,并确定肺移植的最佳候选人。作者使用了来自囊性纤维化基金会患者登记处(CFFPR)的信息,该登记处自1986年以来收集了美国约90%被诊断为囊性纤维化患者的纵向数据。他们通过使用1993年从CFFPR的11,630名患者中随机选取的5,820名患者的数据,开发了多变量逻辑回归模型。对模型进行了拟合优度测试,并对1993年其余的5,810名患者进行了验证。经过验证的5年生存模型包括年龄、一秒用力呼气量占预计正常值的百分比、性别、年龄别体重Z评分、胰腺功能、糖尿病、金黄色葡萄球菌感染、洋葱伯克霍尔德菌感染以及急性肺部加重发作的年度次数。该模型为囊性纤维化的复杂性质提供了见解,并为临床实践和研究提供了一个严谨的工具。