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Ann Rheum Dis:膝关节骨性关节炎高危人群慢步态速度风险分层树的建立和验证

2019-06-27 xiangting MedSci原创

对于膝关节骨性关节炎高危人群,可以使用易于获取的数据来识别功能障碍高危人群。

在骨关节炎导致损伤之前,残疾的预防策略更容易实现。确定高风险人群对于策略实施和试验资格至关重要。一个已确立的指标,步态速度与残疾和死亡率相关。这项研究旨在建立和验证用于膝关节骨性关节炎高风险人群的慢步态速度风险分层树,适用于社区和临床环境。

纳入骨关节炎创议(衍生队列)和多中心骨关节炎研究(验证队列)中的高危膝关节骨性关节炎参与者。结局是长达10年随访期间出现的慢步态。衍生队列分类和回归树分析从易于评估的变量中确定预测因子并建立风险分层模型,然后应用于验证队列。Logistic回归比较了风险组预测值;受试者工作特征曲线下面积(AUCs)总结了辨别力。

纳入1870人(衍生)和1279人(验证)。最简约的风险树确定了三个风险组,来自基于年龄和WOMAC功能的分层。一个7-风险组树还包括了教育、剧烈运动/娱乐活动、肥胖和抑郁症状;11%出现了慢步态速度,在0%-29%(衍生)和2%-23%(验证)间不等,与风险分组有关。两个队列中的AUCs相当(7-风险组树,0.75,95%CI 0.72-0.78(衍生);0.72,95%CI 0.68-0.76(验证))。

对于膝关节骨性关节炎高危人群,可以使用易于获取的数据来识别功能障碍高危人群。结局风险差别很大,与基于风险树的风险分组有关。这些风险树可以告知个体的功能受损风险,并确定预防试验的资格。

原始出处:

Leena Sharma. Development and validation of risk stratification trees for incident slow gait speed in persons at high risk for knee osteoarthritis. Ann Rheum Dis. 26 June 2019.

本文系梅斯医学(MedSci)原创编译整理,转载需授权!


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    2020-01-15 xxxx1061
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    2019-06-29 lmm397
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