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妇科患者支原体感染临床预测模型的建立与验证

Development and Validation of a Clinical Prediction Model for Diagnosing Mycoplasma Infections in Gynecological Patients.

出版信息

Clin Lab. 2024 Sep 1;70(9). doi: 10.7754/Clin.Lab.2024.240215.

DOI:10.7754/Clin.Lab.2024.240215
PMID:39257130
Abstract

BACKGROUND

In adult females, mycoplasma infection is common and challenging to diagnose. This study aimed to use retrospective laboratory data to construct a nomogram for predicting the mycoplasma infection of individuals with probable urogenital tract mycoplasma infection.

METHODS

A total of 2,859 patients with suspected urogenital tract mycoplasma infection were retrospectively enrolled in this study. Demographics and routine examinations of leucorrhea were used to develop a nomogram for predicting mycoplasma infection. The least absolute shrinkage and selection operator (LASSO) method was applied to filter variables and select predictors, and multivariable logistic regression was used to construct a nomogram. The discriminatory ability of the model was determined by calculating the area under the curve (AUC). The performance and clinical utility of the nomogram were generated by using Harrell's concordance index, calibration curve, and decision curve analysis (DCA).

RESULTS

By using the LASSO regression method, seven variables (age, white blood cell, epithetical cell, cleanliness, candidiasis vaginalis, sialidases, and leukocyte esterase) were chosen, and a nomogram was constructed using these variables. The prediction nomogram (0.676, 95% CI: 0.611 - 0.744) demonstrated a satisfactory performance. The prediction model's AUC was 0.679 (95% CI: 0.660 - 0.691). Furthermore, the DCA showed a good clinical net benefit based on the mycoplasma infection nomogram.

CONCLUSIONS

A nomogram was created in this study, which included seven demographic and clinical characteristics of female patients. The nomogram could be of great value for the diagnosis of mycoplasma infection.

摘要

背景

在成年女性中,支原体感染很常见,且难以诊断。本研究旨在利用回顾性实验室数据构建一个列线图,以预测疑似解脲支原体感染的个体的支原体感染。

方法

本研究共纳入 2859 例疑似解脲支原体感染的患者。采用人口统计学和常规白带检查数据来构建预测支原体感染的列线图。应用最小绝对收缩和选择算子(LASSO)方法筛选变量并选择预测因素,采用多变量逻辑回归构建列线图。通过计算曲线下面积(AUC)来评估模型的判别能力。通过计算 Harrell 一致性指数、校准曲线和决策曲线分析(DCA)来评估列线图的性能和临床实用性。

结果

采用 LASSO 回归方法,选择了 7 个变量(年龄、白细胞、上皮细胞、清洁度、假丝酵母菌病、唾液酸酶和白细胞酯酶),并使用这些变量构建了一个列线图。预测列线图(0.676,95%CI:0.611-0.744)表现出较好的性能。预测模型的 AUC 为 0.679(95%CI:0.660-0.691)。此外,DCA 显示基于支原体感染列线图的良好临床净获益。

结论

本研究构建了一个包含女性患者 7 个人口统计学和临床特征的列线图,对于支原体感染的诊断具有重要价值。

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