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基于医疗大数据的统计分析实现唐氏综合征筛查标志物中位数的本土化。

Indigenization of the median of markers for Down syndrome screening based on statistical analysis of medical big data.

机构信息

Center of Reproductive Medicine & Center of Prenatal Diagnosis, First Hospital, Jilin University, Changchun 130021, China.

College of Communication Engineering of Jilin University, Changchun 130000, China.

出版信息

Taiwan J Obstet Gynecol. 2020 Jul;59(4):556-564. doi: 10.1016/j.tjog.2020.05.015.

Abstract

OBJECTIVE

To indigenize the median of Down syndrome (DS) screening markers for first and second trimester, and compare the impact of the indigenized and built-in median data on the efficiency of DS screening.

MATERIALS AND METHODS

Data derived from first and Second-trimester screening (FTS and STS) for DS, composed of selected pregnancies deemed to be normal, were examined in a retrospective study. Indigenization regression analysis was calculated by using five models to fit statistical the raw data. Multiple of median (MoM) values estimated by using indigenized medians were compared with those calculated by using built-in.

RESULTS

This study established a regression equation which is more suitable for the median of each screening marker in the local pregnant women. The changes of median MoM of screening markers were statistically significant after indigenization. For FTS, the detection rate was 100% when the false positive rate was 5%, and the cut-off value was 1/262. On the other hand, for STS, the detection rate of the model with indigenized parameters was 77.42%, which is 16.13% higher than that of built-in parameters.

CONCLUSION

For the individual specific risk of pregnancy, when the indigenized parameters was used to calculate, is more accurately and screening effectiveness has been improved. This is a great reference significance for the current prenatal screening whether indigenized data should be used.

摘要

目的

对唐氏综合征(DS)一、二联筛查标志物中位数进行本土化,比较本土化和内置中位数数据对 DS 筛查效率的影响。

材料与方法

本研究采用回顾性研究方法,对来自一、二联唐氏综合征筛查(FTS 和 STS)的数据进行分析,这些数据来源于被认为正常的选定妊娠。采用五种模型进行本土化回归分析,以拟合原始数据的统计学特征。使用本土化中位数估计的 MoM 值与内置中位数计算的 MoM 值进行比较。

结果

本研究建立了一个更适合本地孕妇各筛查标志物中位数的回归方程。本土化后,各筛查标志物中位数 MoM 的变化具有统计学意义。对于 FTS,当假阳性率为 5%时,检测率为 100%,截断值为 1/262。另一方面,对于 STS,本土化参数模型的检测率为 77.42%,比内置参数模型高 16.13%。

结论

对于个体特定的妊娠风险,当使用本土化参数计算时,结果更准确,筛查效果得到提高。这对当前的产前筛查具有重要的参考意义,即是否应该使用本土化数据。

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