Ireland Colin J, Gordon Andrea L, Thompson Sarah K, Watson David I, Whiteman David C, Reed Richard L, Esterman Adrian
School of Nursing and Midwifery, Division of Health Sciences, University of South Australia, Adelaide, SA, Australia.
School of Pharmacy and Medical Science, Division of Health Sciences, University of South Australia, Adelaide, SA, Australia.
Clin Exp Gastroenterol. 2018 Mar 28;11:135-142. doi: 10.2147/CEG.S158627. eCollection 2018.
Esophageal adenocarcinoma is a disease that has a high mortality rate, the only known precursor being Barrett's esophagus (BE). While screening for BE is not cost-effective at the population level, targeted screening might be beneficial. We have developed a risk prediction model to identify people with BE, and here we present the external validation of this model.
A cohort study was undertaken to validate a risk prediction model for BE. Individuals with endoscopy and histopathology proven BE completed a questionnaire containing variables previously identified as risk factors for this condition. Their responses were combined with data from a population sample for analysis. Risk scores were derived for each participant. Overall performance of the risk prediction model in terms of calibration and discrimination was assessed.
Scores from 95 individuals with BE and 636 individuals from the general population were analyzed. The Brier score was 0.118, suggesting reasonable overall performance. The area under the receiver operating characteristic was 0.83 (95% CI 0.78-0.87). The Hosmer-Lemeshow statistic was =0.14. Minimizing false positives and false negatives, the model achieved a sensitivity of 74% and a specificity of 73%.
This study has validated a risk prediction model for BE that has a higher sensitivity than previous models.
食管腺癌是一种死亡率很高的疾病，唯一已知的前驱病变是巴雷特食管（BE）。虽然在人群层面筛查BE不具有成本效益，但针对性筛查可能有益。我们开发了一种风险预测模型来识别患有BE的人群，在此我们展示该模型的外部验证情况。
开展一项队列研究以验证BE的风险预测模型。经内镜检查和组织病理学证实患有BE的个体完成了一份包含先前确定为此病风险因素的变量的问卷。他们的回答与来自人群样本的数据相结合进行分析。为每位参与者得出风险评分。评估了风险预测模型在校准和区分度方面的总体表现。
分析了95例患有BE的个体和636例普通人群个体的评分。Brier评分为0.118，表明总体表现合理。受试者工作特征曲线下面积为0.83（95%置信区间0.78 - 0.87）。Hosmer-Lemeshow统计量为 =0.14。在尽量减少假阳性和假阴性的情况下，该模型的灵敏度为74%，特异度为73%。
本研究验证了一种用于BE的风险预测模型，该模型比先前的模型具有更高的灵敏度。
