期刊导航

论文摘要

口腔癌患者失志综合征风险预测模型构建及验证

Risk prediction of demoralization syndrome in patients with oral cancer

作者:毛莉艳, 杨茜茜, 毕小琴, 刘敏, 赵重阳, 温作珍

Author:Mao Liyan, Yang Xixi, Bi Xiaoqin, Liu Min, Zhao Chongyang, Wen Zuozhen

收稿日期:2024-09-12          年卷(期)页码:2025,43(3):395-395-405

期刊名称:华西口腔医学杂志

Journal Name:West China Journal of Stomatology

关键字:口腔癌,失志综合征,机器学习,预测模型,

Key words:oral cancer,demoralization syndrome,machine learning,prediction model,

基金项目:四川省科技计划项目(2022JDKP0007);成都市医学科研课题(2022015)

中文摘要

目的 构建口腔癌患者发生失志综合征的风险预测模型,为帮助口腔癌患者更好地应对失志综合征,并为其制定更加个性化的支持方案提供参考依据。 方法 选取2024年3月—7月在四川大学华西口腔医院及中山大学孙逸仙纪念医院共486例口腔癌住院患者作为研究对象。综合分析临床资料和既往研究证据,以确定影响口腔癌患者失志综合征的关键变量。将486例患者按照8∶2的比例分为训练集和验证集,将365例患者的个体数据纳入训练集,基于最小绝对收缩和选择算子(LASSO)回归构建口腔癌失志综合征中重度风险预测模型并构建列线图。采用Bootstrap重采样进行内部验证,通过121例验证组患者的独立数据进行外部验证。 结果 口腔癌患者失志综合征总发生率为83.3%(405例)。其中,轻度失志患者占比48.9%(198例),中度失志患者占比43.4%(176例),重度失志患者占比7.7%(31例)。核心模型包括患者文化水平、疾病了解程度和MDASI-HN评分。模型内部验证结果显示C统计量为0.783 6(95%CI为0.78~0.87),校准斜率为0.843 4,截距为-0.040 6。外部验证集的C统计量为0.80(95%CI为0.71~0.87),校准斜率为0.80,截距为-0.08。 结论 口腔癌患者失志综合征风险预测模型在不同护理环境的验证队列中表现稳健,模型校正良好,具有良好的区分度,可作为入院评估预测项目的参考。

英文摘要

ObjectiveThis study aimed to construct a risk prediction model for the occurrence of the demora-lization syndrome in patients with oral cancer and provide a scientific basis for the prevention of this syndrome in patients with oral cancer and the development of personalized care programs.MethodsA total of 486 patients with oral cancer in West China Hospital of Stomatology of Sichuan University and Sun Yat-sen Memorial Hospital of Sun Yat-sen University from 2024 March to July were selected by convenience sampling. We integrated clinical data and evidence from previous studies to identify the key variables affecting the demoralization syndrome in patients with oral cancer. The 486 patients were divided into a training set and a validation set in an 8∶2 ratio. A clinical risk prediction model was established based on the individual data of 365 patients in the development cohort. Through least absolute shrinkage and selection operator (LASSO) regression, a moderate to severe risk prediction model of demoralization syndrome in oral cancer was constructed, and a clinical machine-learning nomogram was constructed. Bootstrap resampling was used for internal validation. The data of 121 patients in the validation cohort were externally validated.ResultsThe incidence of the demoralization syndrome in patients with oral cancer was 405 cases (83.3%), of which 279 cases (57.4%) were mild, 176 cases (36.2%) were moderate, and 31 cases (6.4%) were severe. The core model, including patient education level, disease understanding, and MDASI-HN score, was used to predict the risk of outcome. Internal validation of the model yielded C statistic of 0.783 6 (95% CI: 0.78-0.87), beta of 0.843 4, and calibration intercept of -0.040 6. Through external validation, the validation set C statistic was 0.80 (95%CI: 0.71-0.87), beta was 0.80, and calibration intercept was -0.08.ConclusionOur risk prediction mo-del of the demoralization syndrome in patients with oral cancer performed robustly in validation cohorts of different nur-sing environments. The model has good correction and good discrimination and can be used as an evaluation and prediction item at admission.

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