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用于新生儿败血症检测的临床预测模型开发与验证,诊断研究方案。

Clinical Prediction Model Development and Validation for the Detection of Newborn Sepsis, Diagnostic Research Protocol.

作者信息

Fenta Feleke Sefineh, Mulu Berihun, Azmeraw Molla, Temesgen Dessie, Dagne Melsew, Giza Mastewal, Yimer Ali, Mengist Dessie Anteneh, Yenew Chalachew

机构信息

Department of Public Health, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia.

Department of Nursing, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia.

出版信息

Int J Gen Med. 2022 Nov 2;15:8025-8031. doi: 10.2147/IJGM.S388120. eCollection 2022.

Abstract

BACKGROUND

Neonatal sepsis is a leading cause of sickness and death in the entire world. Diagnosis is usually difficult because of the nonspecific clinical symptoms and the paucity of laboratory diagnostics in many low- and middle-income nations (LMICs). Clinical prediction models may increase diagnostic precision and rationalize the use of antibiotics in neonatal facilities, which could lead to a decrease in antimicrobial resistance and better neonatal outcomes. Early detection of newborn sepsis is critical to prevent serious consequences and reduce the need for unneeded drugs.

OBJECTIVE

The aim is to develop and validate a clinical prediction model for the detection of newborn sepsis.

METHODS

A cross-sectional study based on an institution will be carried out. The sample size was determined by assuming 10 events per predictor, based on this assumption, the total sample sizes were 467. Data will be collected using a structured checklist through chart review. Data will be coded, inputted, and analyzed using R statistical programming language version 4.0.4 after being entered into Epidata version 3.02 and further processed and analyzed. Bivariable logistic regression will be done to identify the relationship between each predictor and neonatal sepsis. In a multivariable logistic regression model, significant factors (P< 0.05) will be kept, while variables with (P< 0.25) from the bivariable analysis will be added. By calculating the area under the ROC curve (discrimination) and the calibration plot (calibration), respectively, the model's accuracy and goodness of fit will be evaluated.

摘要

背景

新生儿败血症是全球疾病和死亡的主要原因。由于临床症状不具特异性,且许多低收入和中等收入国家(LMICs)缺乏实验室诊断手段,诊断通常较为困难。临床预测模型可能会提高诊断准确性,并使新生儿机构中抗生素的使用更加合理,这可能会导致抗菌药物耐药性降低,并改善新生儿结局。早期发现新生儿败血症对于预防严重后果和减少不必要药物的使用至关重要。

目的

旨在开发并验证一种用于检测新生儿败血症的临床预测模型。

方法

将开展一项基于机构的横断面研究。样本量根据每个预测因素有10个事件的假设来确定,基于此假设,总样本量为467。数据将通过结构化检查表经病历审查收集。数据在录入Epidata 3.02版本后,使用R统计编程语言4.0.4版本进行编码、输入和分析,并进一步处理和分析。将进行双变量逻辑回归以确定每个预测因素与新生儿败血症之间的关系。在多变量逻辑回归模型中,显著因素(P<0.05)将被保留,而双变量分析中P<0.25的变量将被纳入。分别通过计算ROC曲线下面积(辨别力)和校准图(校准)来评估模型的准确性和拟合优度。

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