■许多研究已经开发或验证了预测模型,以估计食管癌(EC)患者术后肺炎(POP)的可能性。这些模型的质量及其对临床实践和未来研究的适用性的评估仍然未知。本研究系统地评估了食管癌手术患者发生POP的风险预测模型的偏倚风险和适用性。
■PubMed,Embase,WebofScience,科克伦图书馆,护理和相关健康文献累积指数(CINAHL),中国国家知识基础设施(CNKI),中国科技期刊数据库(VIP),从开始到2024年3月12日检索万方数据库和中国生物医学文献数据库。两名研究者独立筛选文献并提取数据。采用预测模型偏差风险评估工具(PROBAST)检查表评估偏差风险和适用性。
■共14项研究,涉及23个模型。这些研究主要发表在2014年至2023年之间。所有研究的适用性都很好。然而,所有研究都表现出偏见的高风险,主要归因于不适当的数据源,样本量不足,对变量和缺失数据的不合理处理,缺乏模型验证。食管癌手术患者POP发生率为14.60%~39.26%。最常用的预测因素是吸烟,年龄,慢性阻塞性肺疾病(COPD),糖尿病,开胸手术的方法。模型间判别范围为0.627~0.850,灵敏度为60.7%~84.0%,特异性为59.1%至83.9%。
■在所有纳入的研究中,据报道,食管癌手术患者POP风险预测模型具有良好的区分度,表明模型性能稳定。然而,根据PROBAST检查表,所有研究均存在较高的偏倚风险.未来的研究应使用预测模型评估工具来改进研究设计,并开发具有更大样本和多中心外部验证的新模型。
■https://www.crd.约克。AC.英国/普劳里,标识符CRD42024527085。
UNASSIGNED: Numerous studies have developed or validated prediction models to estimate the likelihood of postoperative pneumonia (POP) in esophageal cancer (EC) patients. The quality of these models and the evaluation of their applicability to clinical practice and future research remains unknown. This study systematically evaluated the risk of bias and applicability of risk prediction models for developing POP in patients undergoing esophageal cancer surgery.
UNASSIGNED: PubMed, Embase, Web of Science, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL),
China National Knowledge Infrastructure (CNKI),
China Science and Technology Journal Database (VIP), WanFang Database and Chinese Biomedical Literature Database were searched from inception to March 12, 2024. Two investigators independently screened the literature and extracted data. The Prediction Model Risk of Bias Assessment Tool (PROBAST) checklist was employed to evaluate both the risk of bias and applicability.
UNASSIGNED: A total of 14 studies involving 23 models were included. These studies were mainly published between 2014 and 2023. The applicability of all studies was good. However, all studies exhibited a high risk of bias, primarily attributed to inappropriate data sources, insufficient sample size, irrational treatment of variables and missing data, and lack of model validation. The incidence of POP in patients undergoing esophageal cancer surgery ranged from 14.60% to 39.26%. The most frequently used predictors were smoking, age, chronic obstructive pulmonary disease(COPD), diabetes mellitus, and methods of thoracotomy. Inter-model discrimination ranged from 0.627 to 0.850, sensitivity ranged between 60.7% and 84.0%, and specificity ranged from 59.1% to 83.9%.
UNASSIGNED: In all included studies, good discrimination was reported for risk prediction models for POP in patients undergoing esophageal cancer surgery, indicating stable model performance. However, according to the PROBAST checklist, all studies had a high risk of bias. Future studies should use the predictive model assessment tool to improve study design and develop new models with larger samples and multicenter external validation.
UNASSIGNED: https://www.crd.york.ac.uk/prospero, identifier CRD42024527085.