疾病严重程度衡量指标的预测能力：对护理研究的启示。
Predictive Ability of an Illness Severity Measure: Implications for Nursing Research.
机构信息
University of Tennessee, Knoxville, TN
The Ohio State University, Columbus, OH.
出版信息
J Nurs Meas. 2021 Aug 1;29(2):213-226. doi: 10.1891/JNM-D-19-00106. Epub 2021 Apr 1.
BACKGROUND AND PURPOSE
Illness severity among children with life-limiting illnesses is measured with the pediatric complex chronic conditions (CCC) measure. Developed in 2000/2001, it was revised in 2014 to include infant-specific categories.
METHODS
Discrimination, calibration, accuracy, and validation tests were used to examine the predictive performance of the measures.
RESULTS
Among the 10,175 infants in the analysis, both measures poorly discriminated-palliative care consultation (C-statistics 0.6396 vs. C-statistics 0.5905) and any inpatient procedure (C-statistics 0.6101 vs. C-statistics 0.5160). The Hosmer-Lemeshow goodness-of-fit tests revealed good calibration for both measures. The original measure was more accurate in predicting end-of-life outcomes-palliative care consultation (Brier Score 0.3892 vs. 0.7787) and any inpatient procedures (Brier Score 0.3115 vs. 0.4738).
CONCLUSIONS
The revised measure did not perform any better than the original in predicting end-of-life outcomes among infants.
背景与目的
采用儿科复杂慢性疾病（CCC）量表来衡量患有生命终末期疾病儿童的疾病严重程度。该量表于 2000/2001 年制定，并于 2014 年进行修订，纳入了针对婴儿的特定类别。
方法
使用区分度、校准度、准确性和验证测试来检查这些测量方法的预测性能。
结果
在分析的 10175 名婴儿中，两种量表的区分能力都较差——姑息治疗咨询（C 统计量分别为 0.6396 和 0.5905）和任何住院治疗（C 统计量分别为 0.6101 和 0.5160）。Hosmer-Lemeshow 拟合优度检验表明，两种量表的校准都较好。原始量表在预测临终结局方面更准确——姑息治疗咨询（Brier 评分分别为 0.3892 和 0.7787）和任何住院治疗（Brier 评分分别为 0.3115 和 0.4738）。
结论
修订后的量表在预测婴儿的临终结局方面并不优于原始量表。
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