Analysis of factors influencing the treatment effect of Bell facial palsy and construction and validation of clinical prediction model
Objective To explore the factors influencing the effect of Bell facial palsy after the treatment,and to construct a clinical prediction model with data and implement validation.Methods From January 2020 to December 2023,323 patients with Bell facial palsy who were treated in the hospital were selected as study objects.All patients were randomly assigned to modeling group(n=226)and validation group(n=97)in a 7∶3 ratio.To described the effect distribution of Bell facial paralysis after acupuncture treat-ment,Univariate and multivariate Logistic regression analysis was performed on the model population to screen out the factors affecting the curative effect and establish a nomogram prediction model.The area under receiver operating characteristic(ROC)curve,GiViTI calibration curve,HosmerLemeshow test and decision analysis curve were used to verify the differentiation,calibration and clinical effectiveness of the 2 groups of population prediction models.Results 226 patients with Bell's facial palsy in the modeling group,125(55.31％)were cured and 101(44.69％)were not cured.Univariate analysis showed that there were significant differences in age,House-Brackman grade,hormone therapy time,acupuncture treatment time and acupuncture treatment plan among the different patients(P＜0.05).Logistic multiva-riate analysis showed that age,House-Brackman grade at the time of the treatment,hormone treatment time,acupuncture treatment time and acupuncture treatment plan were independent influencing factors for the effect of acupuncture treatment for Bell facial palsy(P＜0.05).It had been proved that the area under the ROC curve in the modeling and validation groups was 0.977 and 0.981(both P＞0.05),respectively,indicating that the model was better differentiated.The Bootstrap self-sampling method was used for mod-el verification,and the self-sampling was repeated 1 000 times to obtain the calibration curve of the model-ing group and the validation group.The coincidence degree of the observed value and the predicted value of the 2 calibration curves was good,indicating a good agreement between the predicted value and the actual value.Hosmer-Lemeshow test on modeling group and validation group:modeling group(x2=7.190,P=0.636),validation group(x2=6.236,P=0.801),there was no statistically significant difference,indica-ting high calibration of the model.The decision analysis curve of both modeling group and validation group showed high net benefit,suggesting that the model had clinical validity.Conclusion Patients with Bell's facial palsy still have the possibility of not being cured after the treatment.Patients'age,House-Brackman grade at the time of the treatment,hormone treatment time,acupuncture treatment time and acupuncture treatment plan are independent influencing factors for the treatment effect of Bell's facial palsy,and the clinical prediction model based on this model can accurately predict the treatment effect of the patients.
Bell facial palsyacupuncturetherapeutic effectprediction modelcolumn chart
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