预测消化不良患者的内镜诊断。预测评分模型的价值。
Predicting endoscopic diagnosis in the dyspeptic patient. The value of predictive score models.
作者信息
Bytzer P, Hansen J M, Schaffalitzky de Muckadell O B, Malchow-Møller A
机构信息
Dept. of Medical Gastroenterology S, Odense University Hospital, Denmark.
出版信息
Scand J Gastroenterol. 1997 Feb;32(2):118-25. doi: 10.3109/00365529709000181.
BACKGROUND
Score models to predict endoscopic diagnosis in dyspepsia may compensate for the unreliable clinical diagnosis. This study aimed to construct and test score models designed to predict diagnosis in dyspepstic patients managed in primary care.
METHODS
Three models to predict organic dyspepsia, major dyspepsia, or peptic ulcer were constructed by regression analysis of clinical data from 1026 consecutive dyspeptic patients referred for endoscopy. The models were tested in 207 patients in primary care, who were potential candidates for endoscopy. Validation experiments were analysed using receiver operating characteristic (ROC) curves.
RESULTS
Significant losses of predictive power were found for all models when applied to primary care patients, and no model could be used as a reliable decision support instrument in primary care.
CONCLUSIONS
Predictive score models developed in patients referred for endoscopy are not reliable when applied to patients in primary care who are potential candidates for endoscopy. Future models should be constructed and validated in unselected primary care populations.
背景
用于预测消化不良内镜诊断结果的评分模型可能会弥补不可靠的临床诊断。本研究旨在构建并测试旨在预测基层医疗中消化不良患者诊断结果的评分模型。
方法
通过对1026例连续转诊接受内镜检查的消化不良患者的临床数据进行回归分析，构建了三种预测器质性消化不良、重度消化不良或消化性溃疡的模型。这些模型在207例基层医疗中的患者中进行了测试，这些患者是内镜检查的潜在对象。使用受试者工作特征（ROC）曲线对验证实验进行分析。
结果
当应用于基层医疗患者时，所有模型的预测能力均出现显著下降，且没有模型可作为基层医疗中可靠的决策支持工具。
结论
在内镜检查转诊患者中开发的预测评分模型应用于基层医疗中内镜检查潜在对象时并不可靠。未来的模型应在未选择的基层医疗人群中构建和验证。
Zotero 插件