Perandini Simone, Soardi Gian Alberto, Motton Massimiliano, Rossi Arianna, Signorini Manuel, Montemezzi Stefania
Department of Radiology, Azienda Ospedaliera Universitaria Integrata di Verona, Piazzale Stefani 1, Verona, Italy, 37124.
Eur Radiol. 2016 Sep;26(9):3071-6. doi: 10.1007/s00330-015-4138-9. Epub 2015 Dec 8.
The aim of this study was to compare classification results from four major risk prediction models in a wide population of incidentally detected solitary pulmonary nodules (SPNs) which were selected to crossmatch inclusion criteria for the selected models.
A total of 285 solitary pulmonary nodules with a definitive diagnosis were evaluated by means of four major risk assessment models developed from non-screening populations, namely the Mayo, Gurney, PKUPH and BIMC models. Accuracy was evaluated by receiver operating characteristic (ROC) area under the curve (AUC) analysis. Each model's fitness to provide reliable help in decision analysis was primarily assessed by adopting a surgical threshold of 65 % and an observation threshold of 5 % as suggested by ACCP guidelines.
ROC AUC values, false positives, false negatives and indeterminate nodules were respectively 0.775, 3, 8, 227 (Mayo); 0.794, 41, 6, 125 (Gurney); 0.889, 42, 0, 144 (PKUPH); 0.898, 16, 0, 118 (BIMC).
Resultant data suggests that the BIMC model may be of greater help than Mayo, Gurney and PKUPH models in preoperative SPN characterization when using ACCP risk thresholds because of overall better accuracy and smaller numbers of indeterminate nodules and false positive results.
• The BIMC and PKUPH models offer better characterization than older prediction models • Both the PKUPH and BIMC models completely avoided false negative results • The Mayo model suffers from a large number of indeterminate results.
本研究旨在比较四种主要风险预测模型在大量偶然发现的孤立性肺结节（SPN）人群中的分类结果，这些SPN被选来匹配所选模型的纳入标准。
采用从非筛查人群中开发出的四种主要风险评估模型，即梅奥模型、格尼模型、北大人民医院模型和北京国际医疗中心模型，对总共285个已明确诊断 的孤立性肺结节进行评估。通过受试者操作特征（ROC）曲线下面积（AUC）分析来评估准确性。按照美国胸科医师学会（ACCP）指南的建议，采用65% 的手术阈值和5% 的观察阈值，主要评估每个模型在决策分析中提供可靠帮助的适用性。
ROC AUC值、假阳性、假阴性和不确定结节数分别如下：梅奥模型为0.775、3、8、227；格尼模型为0.794、41、6、125；北大人民医院模型为0.889、42、0、144；北京国际医疗中心模型为0.898、16、0、118。
所得数据表明，在使用ACCP风险阈值时，北京国际医疗中心模型可能比梅奥模型、格尼模型和北大人民医院模型在术前SPN特征描述方面更有帮助，因为其总体准确性更高，不确定结节数和假阳性结果更少。
• 北京国际医疗中心模型和北大人民医院模型比旧的预测模型具有更好的特征描述能力 • 北大人民医院模型和北京国际医疗中心模型均完全避免了假阴性结果 • 梅奥模型存在大量不确定结果。
