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LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00003421naa a2200397 4500
001oai:prod.swepub.kib.ki.se:151806189
003SwePub
008240811s2022 | |||||||||||000 ||eng|
0247 a http://kipublications.ki.se/Default.aspx?queryparsed=id:1518061892 URI
0247 a https://doi.org/10.2340/17453674.2022.45452 DOI
040 a (SwePub)ki
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Hsieh, HC4 aut
2451 0a Can a Bayesian belief network for survival prediction in patients with extremity metastases (PATHFx) be externally validated in an Asian cohort of 356 surgically treated patients?
264 c 2022-09-09
264 1b Medical Journals Sweden AB,c 2022
520 a Background and purpose: Predicted survival may influence the treatment decision for patients with skeletal extremity metastasis, and PATHFx was designed to predict the likelihood of a patient dying in the next 24 months. However, the performance of prediction models could have ethnogeographical variations. We asked if PATHFx generalized well to our Taiwanese cohort consisting of 356 surgically treated patients with extremity metastasis.Patients and methods: We included 356 patients who underwent surgery for skeletal extremity metastasis in a tertiary center in Taiwan between 2014 and 2019 to validate PATHFx’s survival predictions at 6 different time points. Model performance was assessed by concordance index (c-index), calibration analysis, decision curve analysis (DCA), Brier score, and model consistency (MC).Results: The c-indexes for the 1-, 3-, 6-, 12-, 18-, and 24-month survival estimations were 0.71, 0.66, 0.65, 0.69, 0.68, and 0.67, respectively. The calibration analysis demonstrated positive calibration intercepts for survival predictions at all 6 timepoints, indicating PATHFx tended to underestimate the actual survival. The Brier scores for the 6 models were all less than their respective null model’s. DCA demonstrated that only the 6-, 12-, 18-, and 24-month predictions appeared useful for clinical decision-making across a wide range of threshold probabilities. The MC was < 0.9 when the 6- and 12-month models were compared with the 12-month and 18-month models, respectively.Interpretation: In this Asian cohort, PATHFx’s performance was not as encouraging as those of prior validation studies. Clinicians should be cognizant of the potential decline in validity of any tools designed using data outside their particular patient population. Developers of survival prediction tools such as PATHFx might refine their algorithms using data from diverse, contemporary patients that is more reflective of the world’s population.
7001 a Lai, YH4 aut
7001 a Lee, CC4 aut
7001 a Yen, HK4 aut
7001 a Tseng, TE4 aut
7001 a Yang, JJ4 aut
7001 a Lin, SY4 aut
7001 a Hu, MH4 aut
7001 a Hou, CH4 aut
7001 a Yang, RS4 aut
7001 a Wedin, Ru Karolinska Institutet4 aut
7001 a Forsberg, JA4 aut
7001 a Lin, WH4 aut
7102 a Karolinska Institutet4 org
7730 t Acta orthopaedicad : Medical Journals Sweden ABg 93, s. 721-731q 93<721-731x 1745-3682x 1745-3674
8564 8u http://kipublications.ki.se/Default.aspx?queryparsed=id:151806189
8564 8u https://doi.org/10.2340/17453674.2022.4545

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