妊娠期糖尿病风险预测模型的外部验证研究
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女,硕士,护士

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2023年复旦大学护理学院院级科研项目(FNSF202305)


External validation of risk prediction models for gestational diabetes mellitus
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    摘要:

    目的 对妊娠期糖尿病风险预测模型在孕妇人群中进行外部验证和比较,为筛选适宜的预测模型提供依据。方法 采取前瞻性队列研究设计,选取788例建卡的孕妇作为研究对象,分别使用课题组前期经过系统评价遴选出的8个模型预测孕妇妊娠期糖尿病发生风险。通过受试者工作特征曲线下面积、准确度等指标评价模型的预测性能,通过纳入的预测因子评价模型的临床适用性。结果 788例孕妇中,妊娠期糖尿病发病率为10.2%,8个模型的受试者工作特征曲线下面积为0.54~0.67,准确度为0.10~0.90,阴性预测值为0.10~0.89,阳性预测值为0.10~0.96。其中,李金金模型为最佳模型,受试者工作特征曲线下面积为0.66(95%CI 0.60,0.72)、准确度为0.80(95%CI 0.77,0.83),纳入因子数量适宜且易获取,具有良好的临床适用性。结论 针对中国孕妇人群,基于中国数据构建的模型性能表现较好,基于国外数据构建的模型性能表现较差。与其余7个模型相比,李金金模型在中国孕妇队列中的预测性能和临床适用性更具优势。

    Abstract:

    Objective To validate and compare the risk prediction models of gestational diabetes mellitus (GDM) in a prospective cohort study, and to provide suitable prediction tools for screening high-risk pregnant women with GDM.Methods A total of 788 pregnant women with GDM were selected into the research cohort.Eight models were used to predict the risk of GDM in the cohort, and the actual occurrence of GDM was recorded.The predictive performance of the model was evaluated by the area under the receiver operating characteristic curve (AUC), accuracy and other indicators, and the clinical applicability of the model was evaluated by the included predictors.Results The incidence of GDM in the validation dataset was 10.2%.The AUC values of the eight models ranged from 0.54 to 0.67, and the accuracy ranged from 0.10 to 0.90.The negative predictive value was 0.10-0.89, and the positive predictive value was 0.10-0.96. Among them, Li Jinjin model was the best model with an AUC of 0.66 (95%CI 0.60, 0.72) and an accuracy of 0.80 (95%CI 0.77, 0.83).The number of factors included in the model was appropriate and the model was easy to obtain, which had good clinical applicability.Conclusion For Chinese pregnant women, the model based on Chinese data performed well, while the model based on foreign data performed poorly.Compared with the other seven models, Li Jinjin model had better predictive performance and clinical applicability in the Chinese pregnant women cohort.

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陈姝宇,周英凤,郭娜菲,李丽.妊娠期糖尿病风险预测模型的外部验证研究[J].护理学杂志,2025,(1):46-50

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  • 收稿日期:2024-07-24
  • 最后修改日期:2024-10-06
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  • 在线发布日期: 2025-02-10