Nomograms in oncology: more than meets the eye.
Nomograms in oncology: more than meets the eye.
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DOI：
10.1016/s1470-2045(14)71116-7
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发表时间：
2015-04
期刊：
影响因子：
--
通讯作者：
DeMatteo RP
中科院分区：
文献类型：
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作者：
Balachandran VP;Gonen M;Smith JJ;DeMatteo RP
列线图是肿瘤学和医学中估计预后的常用工具。通过整合不同的预后和决定性变量来生成临床事件的个体数值概率的能力，列线图满足了我们对生物学和临床整合模型的需求以及我们对个性化医疗的驱动。通过用户友好的数字界面进行快速计算，与传统分期相比，准确性提高，并且更容易理解，允许无缝结合诺模图导出的预后，以帮助临床决策。这导致了诺模图在互联网和医学期刊上的普遍出现，并且越来越多的患者和医生使用诺模图。然而，诺模图构建的统计基础、其精确解释以及支持其使用的证据通常被误解，导致对诺模图使用的固有不确定性的低估。我们提供了一个系统的，实用的方法来评估和理解诺模图导出的图表，特别强调澄清常见的误解和突出的局限性。
Nomograms are commonly used tools to estimate prognosis in oncology and medicine. With the ability to generate an individual numerical probability of a clinical event by integrating diverse prognostic and determinant variables, nomograms fulfill our desire for biologically and clinically integrated models and our drive towards personalized medicine. Rapid computation through user friendly digital interfaces, together with increased accuracy, and more easily understood prognoses compared to conventional staging, allow for seamless incorporation of nomogram derived prognosis to aid in clinical decision making. This has lead to the ubiquitous appearance of nomograms on the internet and in medical journals, and increasing nomogram use by patients and physicians alike. However, the statistical foundations of nomogram construction, their precise interpretation, and evidence supporting their use is commonly misunderstood, leading to an under appreciation of the inherent uncertainties regarding nomogram use. We provide a systematic, practical approach to evaluating and comprehending nomogram derived prognoses, with particular emphasis on clarifying common misconceptions and highlighting limitations.