Luo Yu, Xu Guangcan, Li Hongyu, Ma Tianju, Ye Zi, Li Zhaohui
Medical School of Chinese People's Liberation Army, No. 28 Fuxing Road, Haidian District, Beijing 100853, China.
Department of Ophthalmology, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China.
J Clin Med. 2023 Feb 6;12(4):1290. doi: 10.3390/jcm12041290.
Corneal edema (CE) affects the outcome of phacoemulsification. Effective ways to predict the CE after phacoemulsification are needed.
On the basis of data from patients conforming to the protocol of the AGSPC trial, 17 variables were selected to predict CE after phacoemulsification by constructing a CE nomogram through multivariate logistic regression, which was improved via variable selection with copula entropy. The prediction models were evaluated using predictive accuracy, the area under the receiver operating characteristic curve (AUC), and decision curve analysis (DCA).
Data from 178 patients were used to construct prediction models. After copula entropy variable selection, which shifted the variables used for prediction in the CE nomogram from diabetes, best corrected visual acuity (BCVA), lens thickness and cumulative dissipated energy (CDE) to CDE and BCVA in the Copula nomogram, there was no significant change in predictive accuracy (0.9039 vs. 0.9098). There was also no significant difference in AUCs between the CE nomogram and the Copula nomogram (0.9637, 95% CI 0.9329-0.9946 vs. 0.9512, 95% CI 0.9075-0.9949; = 0.2221). DCA suggested that the Copula nomogram has clinical application.
This study obtained a nomogram with good performance to predict CE after phacoemulsification, and showed the improvement of copula entropy for nomogram models.
角膜水肿（CE）会影响超声乳化手术的效果。需要有效的方法来预测超声乳化术后的角膜水肿。
基于符合AGSPC试验方案的患者数据，通过多因素逻辑回归构建角膜水肿列线图来选择17个变量以预测超声乳化术后的角膜水肿，并通过基于Copula熵的变量选择对其进行改进。使用预测准确性、受试者操作特征曲线下面积（AUC）和决策曲线分析（DCA）对预测模型进行评估。
使用178例患者的数据构建预测模型。在基于Copula熵的变量选择后，角膜水肿列线图中用于预测的变量从糖尿病、最佳矫正视力（BCVA）、晶状体厚度和累积消散能量（CDE）转变为Copula列线图中的CDE和BCVA，预测准确性无显著变化（0.9039对0.9098）。角膜水肿列线图和Copula列线图之间的AUC也无显著差异（0.9637，95%CI 0.9329 - 0.9946对0.9512，95%CI 0.9075 - 0.9949；P = 0.2221）。DCA表明Copula列线图具有临床应用价值。
本研究获得了一个性能良好的列线图来预测超声乳化术后的角膜水肿，并展示了Copula熵对列线图模型的改进作用。
