Application of a practice-based approach in variable selection for a prediction model development study of hospital-induced delirium.
Application of a practice-based approach in variable selection for a prediction model development study of hospital-induced delirium.
复制标题
基于实践的变量选择方法在医院诱发性谵妄预测模型开发研究中的应用。
DOI：
10.1186/s12911-023-02278-1
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发表时间：
2023-09-13
影响因子：
3.5
通讯作者：
Lucero, Robert J.
中科院分区：
文献类型：
--
作者：
Snigurska, Urszula A.;Ser, Sarah E.;Solberg, Laurence M.;Prosperi, Mattia;Magoc, Tanja;Chen, Zhaoyi;Bian, Jiang;Bjarnadottir, Ragnhildur I.;Lucero, Robert J.
关键词：
医院引起的谵妄的预后模型，包括潜在的诱发因素和诱发因素，可用于识别脆弱的患者，并为实施量身定制的预防性干预措施提供信息。建议在预测模型开发研究中，根据现有知识（包括临床实践知识）选择候选预测因子。本文的目的是描述识别和操作医院诱发谵妄的候选预测因子的过程，以应用于使用基于实践的方法的预测模型开发研究。本研究是一项更大规模的回顾性队列研究的一部分，该研究正在使用来自行政和电子健康记录的结构化数据为内科手术老年患者开发医院诱导性谵妄的预后模型。首先，我们对文献进行了回顾，以确定在医院诱导性谵妄的预后模型开发和验证研究中用作候选预测因子的临床概念。然后，我们咨询了一个由9名成员组成的多学科工作组，他们独立判断每个临床概念是否与医院引起的谵妄有关。最后，我们将临床概念映射到行政和电子健康记录，并将我们的候选预测因子操作化。在对34项研究的回顾中，我们确定了504个独特的临床概念。三分之二的临床概念（337/504）仅被用作候选预测因子一次。最常见的临床概念包括年龄（31/34）、性别（29/34）和饮酒（22/34）。96%的临床概念（484/504）被至少两名工作组成员判定为与医院诱导性谵妄的发生相关。所有的工作组成员都同意，504个临床概念中有47个或9%与医院引起的谵妄有关。在文献中，医院诱导性谵妄的候选预测因素之间的异质性表明，仍在不断发展的因素，有助于这种复杂现象的发展。我们展示了一种基于实践的方法，为我们的医院诱导性谵妄模型开发研究的变量选择。专家对变量的判断使我们能够根据专家之间的一致性对变量进行分类，并计划开发不同的模型，包括专家模型和数据驱动模型。在线版本包含补充材料，可通过10.1186/s12911-023-02278-1获得。
Prognostic models of hospital-induced delirium, that include potential predisposing and precipitating factors, may be used to identify vulnerable patients and inform the implementation of tailored preventive interventions. It is recommended that, in prediction model development studies, candidate predictors are selected on the basis of existing knowledge, including knowledge from clinical practice. The purpose of this article is to describe the process of identifying and operationalizing candidate predictors of hospital-induced delirium for application in a prediction model development study using a practice-based approach. This study is part of a larger, retrospective cohort study that is developing prognostic models of hospital-induced delirium for medical-surgical older adult patients using structured data from administrative and electronic health records. First, we conducted a review of the literature to identify clinical concepts that had been used as candidate predictors in prognostic model development-and-validation studies of hospital-induced delirium. Then, we consulted a multidisciplinary task force of nine members who independently judged whether each clinical concept was associated with hospital-induced delirium. Finally, we mapped the clinical concepts to the administrative and electronic health records and operationalized our candidate predictors. In the review of 34 studies, we identified 504 unique clinical concepts. Two-thirds of the clinical concepts (337/504) were used as candidate predictors only once. The most common clinical concepts included age (31/34), sex (29/34), and alcohol use (22/34). 96% of the clinical concepts (484/504) were judged to be associated with the development of hospital-induced delirium by at least two members of the task force. All of the task force members agreed that 47 or 9% of the 504 clinical concepts were associated with hospital-induced delirium. Heterogeneity among candidate predictors of hospital-induced delirium in the literature suggests a still evolving list of factors that contribute to the development of this complex phenomenon. We demonstrated a practice-based approach to variable selection for our model development study of hospital-induced delirium. Expert judgement of variables enabled us to categorize the variables based on the amount of agreement among the experts and plan for the development of different models, including an expert-model and data-driven model. The online version contains supplementary material available at 10.1186/s12911-023-02278-1.
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影响因子：
158.5
作者：
Inouye, SK;Bogardus, ST;Cooney, LW
通讯作者：
Cooney, LW
影响因子：
168.9
作者：
Inouye, Sharon K.;Westendorp, Rudi G. J.;Saczynski, Jane S.
通讯作者：
Saczynski, Jane S.
影响因子：
--
作者：
Pisani, Margaret A.;Murphy, Terrence E.;Inouye, Sharon K.
通讯作者：
Inouye, Sharon K.
影响因子：
39.2
作者：
Collins, Gary S.;Reitsma, Johannes B.;Moons, Karel G. M.
通讯作者：
Moons, Karel G. M.
DOI：
10.13063/2327-9214.1079
发表时间：
2014-01-01
期刊：
EGEMS (Washington, DC)
影响因子：
--
作者：
Capurro, Daniel;Yetisgen, Meliha;Tarczy-Hornoch, Peter
通讯作者：
Tarczy-Hornoch, Peter