Sökning: WFRF:(Lai MH) > Can a Bayesian beli...
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000 | 03421naa a2200397 4500 | |
001 | oai:prod.swepub.kib.ki.se:151806189 | |
003 | SwePub | |
008 | 240811s2022 | |||||||||||000 ||eng| | |
024 | 7 | a http://kipublications.ki.se/Default.aspx?queryparsed=id:1518061892 URI |
024 | 7 | a https://doi.org/10.2340/17453674.2022.45452 DOI |
040 | a (SwePub)ki | |
041 | a engb eng | |
042 | 9 SwePub | |
072 | 7 | a ref2 swepub-contenttype |
072 | 7 | a art2 swepub-publicationtype |
100 | 1 | a Hsieh, HC4 aut |
245 | 1 0 | a 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 | 1 | b 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. | |
700 | 1 | a Lai, YH4 aut |
700 | 1 | a Lee, CC4 aut |
700 | 1 | a Yen, HK4 aut |
700 | 1 | a Tseng, TE4 aut |
700 | 1 | a Yang, JJ4 aut |
700 | 1 | a Lin, SY4 aut |
700 | 1 | a Hu, MH4 aut |
700 | 1 | a Hou, CH4 aut |
700 | 1 | a Yang, RS4 aut |
700 | 1 | a Wedin, Ru Karolinska Institutet4 aut |
700 | 1 | a Forsberg, JA4 aut |
700 | 1 | a Lin, WH4 aut |
710 | 2 | a Karolinska Institutet4 org |
773 | 0 | t Acta orthopaedicad : Medical Journals Sweden ABg 93, s. 721-731q 93<721-731x 1745-3682x 1745-3674 |
856 | 4 8 | u http://kipublications.ki.se/Default.aspx?queryparsed=id:151806189 |
856 | 4 8 | u https://doi.org/10.2340/17453674.2022.4545 |
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