Hu Rongrong, Marín-Franch Iván, Racette Lyne
Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China Indiana University, Eugene and Marilyn Glick Eye Institute, Indianapolis, Indiana, United States.
Departamento de Óptica, Facultad de Física, Universitat de València, Burjassot, Spain.
Invest Ophthalmol Vis Sci. 2014 Oct 30;55(12):8086-94. doi: 10.1167/iovs.14-14928.
To assess the prediction accuracy of a novel dynamic structure-function (DSF) model to monitor glaucoma progression.
Longitudinal data of paired rim area (RA) and mean sensitivity (MS) from 220 eyes with ocular hypertension or primary open-angle glaucoma enrolled in the Diagnostic Innovations in Glaucoma Study or the African Descent and Glaucoma Evaluation Study were included. Rim area and MS were expressed as percent of mean normal based on an independent dataset of 91 healthy eyes. The DSF model uses centroids as estimates of the current state of the disease and velocity vectors as estimates of direction and rate of change over time. The first three visits were used to predict the fourth visit; the first four visits were used to predict the fifth visit, and so on up to the 11th visit. The prediction error (PE) was compared to that of ordinary least squares linear regression (OLSLR) using Wilcoxon signed-rank test.
For predictions at visit 4 to visit 7, the average PE for the DSF model was significantly lower than OLSLR by 1.19% to 3.42% of mean normal. No significant difference was observed for the predictions at visit 8 to visit 11. The DSF model had lower PE than OLSLR for 70% of eyes in predicting visit 4 and approximately 60% in predicting visits 5, 6, and 7.
The two models had similar prediction capabilities, and the DSF model performed better in shorter time series. The DSF model could be clinically useful when only limited follow-ups are available. (ClinicalTrials.gov numbers, NCT00221923, NCT00221897.).
评估一种新型动态结构-功能(DSF)模型监测青光眼进展的预测准确性。
纳入了青光眼诊断创新研究或非洲裔与青光眼评估研究中220只高眼压或原发性开角型青光眼患眼的配对视盘面积(RA)和平均敏感度(MS)的纵向数据。视盘面积和MS根据91只健康眼睛的独立数据集表示为正常均值的百分比。DSF模型使用质心作为疾病当前状态的估计值,并使用速度向量作为随时间变化的方向和速率的估计值。前三次就诊用于预测第四次就诊;前四次就诊用于预测第五次就诊,依此类推,直至第十一次就诊。使用Wilcoxon符号秩检验将预测误差(PE)与普通最小二乘线性回归(OLSLR)的预测误差进行比较。
对于第4次至第7次就诊的预测,DSF模型的平均PE比OLSLR显著低正常均值的1.19%至3.42%。在第8次至第11次就诊的预测中未观察到显著差异。在预测第4次就诊时,70%的患眼中DSF模型的PE低于OLSLR,在预测第5次、第6次和第7次就诊时,这一比例约为60%。
两种模型具有相似的预测能力,DSF模型在较短时间序列中表现更好。当仅有有限的随访数据时,DSF模型在临床上可能有用。(ClinicalTrials.gov编号,NCT00221923,NCT00221897。)