Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Sci Rep. 2024 Mar 22;14(1):6862. doi: 10.1038/s41598-024-57396-1.
This study aims to develop and validate nomogram models utilizing clinical and thoracic aorta imaging factors to assess the risk of hypertension for lung cancer screening cohorts. We included 804 patients and collected baseline clinical data, biochemical indicators, coexisting conditions, and thoracic aorta factors. Patients were randomly divided into a training set (70%) and a validation set (30%). In the training set, variance, t-test/Mann-Whitney U-test and standard least absolute shrinkage and selection operator were used to select thoracic aorta imaging features for constructing the AIScore. Multivariate logistic backward stepwise regression was utilized to analyze the influencing factors of hypertension. Five prediction models (named AIMeasure model, BasicClinical model, TotalClinical model, AIBasicClinical model, AITotalClinical model) were constructed for practical clinical use, tailored to different data scenarios. Additionally, the performance of the models was evaluated using receiver operating characteristic (ROC) curves, calibration curves and decision curve analyses (DCA). The areas under the ROC curve for the five models were 0.73, 0.77, 0.83, 0.78, 0.84 in the training set, and 0.77, 0.78, 0.81, 0.78, 0.82 in the validation set, respectively. Furthermore, the calibration curves and DCAs of both sets performed well on accuracy and clinical practicality. The nomogram models for hypertension risk prediction demonstrate good predictive capability and clinical utility. These models can serve as effective tools for assessing hypertension risk, enabling timely non-pharmacological interventions to preempt or delay the future onset of hypertension.
本研究旨在开发和验证列线图模型,利用临床和胸主动脉影像学因素评估肺癌筛查队列中高血压的风险。我们纳入了 804 名患者,并收集了基线临床数据、生化指标、并存疾病和胸主动脉因素。患者被随机分为训练集(70%)和验证集(30%)。在训练集中,使用方差分析、t 检验/曼-惠特尼 U 检验和标准最小绝对收缩和选择算子选择胸主动脉影像学特征来构建 AIScore。多变量逻辑向后逐步回归用于分析高血压的影响因素。为了实际的临床应用,构建了五个预测模型(命名为 AIMeasure 模型、BasicClinical 模型、TotalClinical 模型、AIBasicClinical 模型、AITotalClinical 模型),针对不同的数据情况进行了调整。此外,使用接受者操作特征(ROC)曲线、校准曲线和决策曲线分析(DCA)评估模型的性能。五个模型在训练集和验证集中的 ROC 曲线下面积分别为 0.73、0.77、0.83、0.78、0.84 和 0.77、0.78、0.81、0.78、0.82。此外,两组的校准曲线和 DCA 在准确性和临床实用性方面表现良好。高血压风险预测的列线图模型具有良好的预测能力和临床实用性。这些模型可以作为评估高血压风险的有效工具,实现及时的非药物干预,以预防或延迟未来高血压的发生。