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基于中国一项10年回顾性队列研究的高血压预测列线图的开发与验证

Development and validation of a nomogram to better predict hypertension based on a 10-year retrospective cohort study in China.

作者信息

Deng Xinna, Hou Huiqing, Wang Xiaoxi, Li Qingxia, Li Xiuyuan, Yang Zhaohua, Wu Haijiang

机构信息

Departments of Oncology & Immunotherapy, Hebei General Hospital, Shijiazhuang, China.

Physical Examination Center, Hebei General Hospital, Shijiazhuang, China.

出版信息

Elife. 2021 May 28;10:e66419. doi: 10.7554/eLife.66419.

Abstract

BACKGROUND

Hypertension is a highly prevalent disorder. A nomogram to estimate the risk of hypertension in Chinese individuals is not available.

METHODS

6201 subjects were enrolled in the study and randomly divided into training set and validation set at a ratio of 2:1. The LASSO regression technique was used to select the optimal predictive features, and multivariate logistic regression to construct the nomograms. The performance of the nomograms was assessed and validated by AUC, C-index, calibration curves, DCA, clinical impact curves, NRI, and IDI.

RESULTS

The nomogram was developed with the parameters of family history of hypertension, age, SBP, DBP, BMI, MCHC, MPV, TBIL, and TG. AUCs of nomogram were 0.750 in the training set and 0.772 in the validation set. C-index of nomogram were 0.750 in the training set and 0.772 in the validation set. The nomogram was developed with the parameters of family history of hypertension, age, SBP, DBP, RDWSD, and TBIL. AUCs of nomogram were 0.705 in the training set and 0.697 in the validation set. C-index of nomogram were 0.705 in the training set and 0.697 in the validation set. Both nomograms demonstrated favorable clinical consistency. NRI and IDI showed that the nomogram exhibited superior performance than the nomogram. Therefore, the web-based calculator of nomogram was built online.

CONCLUSIONS

We have constructed a nomogram that can be effectively used in the preliminary and in-depth risk prediction of hypertension in a Chinese population based on a 10-year retrospective cohort study.

FUNDING

This study was supported by the Hebei Science and Technology Department Program (no. H2018206110).

摘要

背景

高血压是一种高度流行的疾病。目前尚无用于估计中国人群高血压风险的列线图。

方法

6201名受试者参与本研究,并按2:1的比例随机分为训练集和验证集。采用LASSO回归技术选择最佳预测特征,并通过多变量逻辑回归构建列线图。通过AUC、C指数、校准曲线、决策曲线分析(DCA)、临床影响曲线、净重新分类指数(NRI)和综合鉴别改善指数(IDI)对列线图的性能进行评估和验证。

结果

基于高血压家族史、年龄、收缩压、舒张压、体重指数、平均红细胞血红蛋白浓度、平均血小板体积、总胆红素和甘油三酯等参数构建了列线图。训练集中列线图的AUC为0.750,验证集中为0.772。训练集中列线图的C指数为0.750,验证集中为0.772。基于高血压家族史、年龄、收缩压、舒张压、红细胞分布宽度标准差和总胆红素等参数构建了列线图。训练集中列线图的AUC为0.705,验证集中为0.697。训练集中列线图的C指数为0.705,验证集中为0.697。两个列线图均显示出良好的临床一致性。NRI和IDI表明该列线图的性能优于另一个列线图。因此,在线构建了列线图的网络计算器。

结论

基于一项10年回顾性队列研究,我们构建了一个可有效用于中国人群高血压初步和深入风险预测的列线图。

资助

本研究得到河北省科学技术厅项目(编号:H2018206110)的支持。

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