Analysis of predicative factors and model construction of clinical efficacy of invigorating spleen and kidney and invigorating qi and blood in the treatment of aplastic anemia
[Objective]To explore the clinical predictive factors related to the efficacy of spleen and kidney tonifying and qi and blood toning in the treatment of Aplastic Anemia(AA),and construct a nomogram that can predict the effectiveness of spleen and kidney toning and qi and blood toning in the treatment of AA.[Methods]The clinical data and follow-up information of 585 patients with AA who were treated by tonifying spleen and kidney and tonifying qi and blood in 19 hospitals across the country from May 2018 to June 2021 were collected,and a retrospective observational study was conducted.A total of 243 patients were divided into an effective group and an ineffective group according to whether the short-term treatment was effective or not.Univariate analysis was used to explore the clinical predictors of AA invigorating the spleen and kidney and tonifying qi and blood.Binary Logistic regression was used to analyze the relevant clinical predictors.Use R language to make a nomogram prediction model and build a dynamic nomogram.Bootstrap self-sampling method was used for internal verification,C index,calibration curve,and Hosmer-Lemeshow goodness-of-fit test were used to evaluate the discrimination and calibration of the model,and the DCA decision curve to evaluate the clinical validity of the model.[Results]Multivariate logistic regression screened out 5 predictors:disease course,AA type,BMI≥25,TCM treatment plan and blood transfusion dependence.The nomogram constructed in this study was composed of the above 5 variables.The C index and the area under the ROC curve(AUC)of the prediction model constructed in this study were both 0.754(95%CI:0.677-0.830);the calibration curve and goodness of fit test(χ2=3.525,P=0.897)showed a good consistent;decision curves show a higher net benefit value when the threshold probability is 32%to 94%.[Conclusion]The predictive model constructed in this study has a good ability to predict the efficacy of integrated Chinese and Western medicine in the treatment of aplastic anemia patients.
aplastic anemiaintegrated traditional Chinese and Western medicinecurative effectprediction modelnomogram
万方数据
维普
