M'Pembele René, Roth Sebastian, Lurati Buse Giovanna
Klinik für Anästhesiologie, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
CARID (Cardiovascular Research Institute Düsseldorf), Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität, Düsseldorf, Deutschland.
Anaesthesiologie. 2024 Dec;73(12):861-870. doi: 10.1007/s00101-024-01481-7. Epub 2024 Nov 22.
Risk prediction models are an established component of the preoperative evaluation. In its guidelines the European Society for Cardiology proposes several risk scores but the benefit of these is mostly unclear for clinicians. This article describes the individual steps in the preparation of a valid prediction model with a focus on the parameters, discrimination, calibration and external validation. The clinical benefits of the risk scores proposed in the guidelines with respect to these parameters was investigated. All proposed risk scores appear to show a good discrimination in the validation cohorts. Only a few reliable data for a good calibration could be compiled. The external validity of the individual models is unclear. The general benefit of the risk scores cannot be recommended as data for calibration or discrimination in external cohorts are lacking. A precise estimation of the risk cannot be expected.
风险预测模型是术前评估的既定组成部分。欧洲心脏病学会在其指南中提出了几种风险评分,但这些评分对临床医生的益处大多尚不清楚。本文描述了构建有效预测模型的各个步骤,重点关注参数、区分度、校准和外部验证。研究了指南中提出的风险评分在这些参数方面的临床益处。所有提出的风险评分在验证队列中似乎都显示出良好的区分度。仅能收集到少数关于良好校准的可靠数据。各个模型的外部有效性尚不清楚。由于缺乏外部队列中校准或区分度的数据,风险评分的总体益处无法得到推荐。无法期望对风险进行精确估计。