首页 期刊 论文 学科刊群 资讯 加盟 关于
EN
image
Article(id=1240950903231017722, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240950898113966774, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202307262, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1689350400000, receivedDateStr=2023-07-15, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773795351082, onlineDateStr=2026-03-18, pubDate=1712678400000, pubDateStr=2024-04-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773795351082, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773795351082, creator=13701087609, updateTime=1773795351082, updator=13701087609, issue=Issue{id=1240950898113966774, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='7', pageStart='1153', pageEnd='1344', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773795349862, creator=13701087609, updateTime=1773795519367, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1240951609136567133, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240950898113966774, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1240951609136567134, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240950898113966774, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1161, endPage=1165, ext={EN=ArticleExt(id=1240950903549784843, articleId=1240950903231017722, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Comparison of the application value of two prediction models in the prediction of post-stroke fatigue risk in stroke patients, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore and compare the application value of post-stroke fatigue (PSF) risk prediction nomogram and Web calculator program in post-stroke fatigue risk prediction in convalescent stroke patients.

Methods

The patients with acute stroke admitted to the Department of Encephalopathy of a tertiary hospital from February 2023 to August 2023 were prospectively selected, and the nomogram and Web calculator program were used to predict the risk probability of PSF in convalescent stage. The area under the receiver operating characteristic curve (AUC), Hosmer-Lemeshow goodness-of-fit test, and clinical decision curve were used to evaluate the discrimination, calibration, and clinical utility of the two models, respectively.

Results

A total of 282 patients were included, of which 128 had PSF, and the incidence of PSF was 46.89%. The AUC of the nomogram and Web calculator were 0.687 (95%CI:0.624-0.749) and 0.743 (95%CI: 0.683-0.803), respectively. The Hosmer-Lemeshow goodness-of-fit test showed that the nomogram (χ2=8.357, P=0.213) and Web calculator program (χ2=4.467, P=0.614) were well fitted in stroke patients. The clinical decision curve analysis showed that the nomogram and Web calculator program had clinical benefits in the range of threshold probability of 0.35-0.81 and 0.33-0.88, respectively.

Conclusion

The nomogram and Web calculator program can effectively predict the PSF risk of stroke convalescent patients, and the Web calculator program is superior to the nomogram. However, the future Web calculator program model still needs to be further updated to balance simplicity and accuracy, thereby improving its clinical applicability.

, correspAuthors=null, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, authorCompany=null, fund=null, authors=null, authorsList=Jin-pan YANG, Qiu-ping MA, Yu-jun LIU, Jia-lin ZHANG), CN=ArticleExt(id=1240950905097483129, articleId=1240950903231017722, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=两种预测模型在脑卒中患者卒中后疲劳风险预测中的应用价值比较, columnId=1228016567632462653, journalTitle=现代预防医学, columnName=流行病与统计方法, runingTitle=null, highlight=null, articleAbstract=
目的

探讨并比较分析脑卒中后疲劳(post-stroke fatigue, PSF)风险预测列线图和Web计算器程序在脑卒中恢复期患者PSF风险预测中的应用价值。

方法

前瞻性选取某家三甲医院脑病科2023年2—8月收治的急性期卒中患者，使用列线图和Web计算器程序预测每位卒中患者未来在恢复期发生PSF的风险概率。应用受试者工作特征曲线下面积(area under curve, AUC)、Hosmer-Lemeshow拟合优度检验、临床决策曲线分别评价两种模型的区分度、校准度和临床效用。

结果

共纳入282例卒中患者，其中128例发生PSF，PSF发生率为46.89%。列线图和Web计算器程序的AUC分别为0.687(95%CI: 0.624～0.749)、0.743(95%CI: 0.683～0.803)。Hosmer-Lemeshow拟合优度检验提示，列线图(χ2=8.357，P=0.213)和Web计算器程序(χ2=4.467，P=0.614)在卒中患者中的拟合度良好。临床决策曲线分析显示，列线图和Web计算器程序分别在阈概率0.35～0.81、0.33～0.88范围内有临床获益。

结论

列线图和Web计算器程序能有效预测卒中恢复期患者的PSF风险，Web计算器程序优于列线图。但未来Web计算器程序模型仍需进一步更新以平衡简便性和准确性，进而提高其临床适用性。

, correspAuthors=null, authorNote=null, correspAuthorsNote=
马秋平，E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=IyJ6QyIdrSgXV/uMDgBB1w==, magXml=1R9P8mVyg5v/kSXUhuOz/w==, pdfUrl=null, pdf=kfym+dI88WfKxG3+f+GLJQ==, pdfFileSize=677280, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=0JTp6lWEWjRzGgjr+pm1dA==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=cdich5ufwFvdnUqrx9j/GQ==, mapNumber=null, authorCompany=null, fund=null, authors=

杨金盘（1994—），男，硕士在读，研究方向：老年常见疾病的防治

, authorsList=杨金盘, 马秋平, 刘裕君, 张佳琳)}, authors=[Author(id=1240972162518012245, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1240972162631258461, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, authorId=1240972162518012245, language=EN, stringName=Jin-pan YANG, firstName=Jin-pan, middleName=null, lastName=YANG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Guangxi University of Chinese Medicine, Nanning, Guangxi 530200, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1240972162748698985, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, authorId=1240972162518012245, language=CN, stringName=杨金盘, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=广西中医药大学，广西 南宁 530200, bio={"content":"

杨金盘（1994—），男，硕士在读，研究方向：老年常见疾病的防治

"}, bioImg=null, bioContent=

杨金盘（1994—），男，硕士在读，研究方向：老年常见疾病的防治

, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1240972162396377422, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, xref=null, ext=[AuthorCompanyExt(id=1240972162408960335, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, companyId=1240972162396377422, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Guangxi University of Chinese Medicine, Nanning, Guangxi 530200, China), AuthorCompanyExt(id=1240972162421543248, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, companyId=1240972162396377422, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=广西中医药大学，广西 南宁 530200)])]), Author(id=1240972162836779381, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, orderNo=1, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=396793934@qq.com, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1240972163000357249, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, authorId=1240972162836779381, language=EN, stringName=Qiu-ping MA, firstName=Qiu-ping, middleName=null, lastName=MA, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Guangxi University of Chinese Medicine, Nanning, Guangxi 530200, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1240972163142963595, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, authorId=1240972162836779381, language=CN, stringName=马秋平, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=广西中医药大学，广西 南宁 530200, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1240972162396377422, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, xref=null, ext=[AuthorCompanyExt(id=1240972162408960335, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, companyId=1240972162396377422, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Guangxi University of Chinese Medicine, Nanning, Guangxi 530200, China), AuthorCompanyExt(id=1240972162421543248, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, companyId=1240972162396377422, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=广西中医药大学，广西 南宁 530200)])]), Author(id=1240972163281375643, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, orderNo=2, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1240972163403010472, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, authorId=1240972163281375643, language=EN, stringName=Yu-jun LIU, firstName=Yu-jun, middleName=null, lastName=LIU, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Guangxi University of Chinese Medicine, Nanning, Guangxi 530200, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1240972163512062386, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, authorId=1240972163281375643, language=CN, stringName=刘裕君, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=广西中医药大学，广西 南宁 530200, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1240972162396377422, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, xref=null, ext=[AuthorCompanyExt(id=1240972162408960335, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, companyId=1240972162396377422, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Guangxi University of Chinese Medicine, Nanning, Guangxi 530200, China), AuthorCompanyExt(id=1240972162421543248, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, companyId=1240972162396377422, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=广西中医药大学，广西 南宁 530200)])]), Author(id=1240972163616919999, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, orderNo=3, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1240972163776303565, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, authorId=1240972163616919999, language=EN, stringName=Jia-lin ZHANG, firstName=Jia-lin, middleName=null, lastName=ZHANG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Guangxi University of Chinese Medicine, Nanning, Guangxi 530200, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1240972163881161171, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, authorId=1240972163616919999, language=CN, stringName=张佳琳, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=广西中医药大学，广西 南宁 530200, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1240972162396377422, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, xref=null, ext=[AuthorCompanyExt(id=1240972162408960335, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, companyId=1240972162396377422, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Guangxi University of Chinese Medicine, Nanning, Guangxi 530200, China), AuthorCompanyExt(id=1240972162421543248, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, companyId=1240972162396377422, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=广西中医药大学，广西 南宁 530200)])])], keywords=[Keyword(id=1240972164099265002, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, language=EN, orderNo=1, keyword=Stroke patients), Keyword(id=1240972164204122607, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, language=EN, orderNo=2, keyword=Post stroke fatigue), Keyword(id=1240972164313174522, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, language=EN, orderNo=3, keyword=Predictive model), Keyword(id=1240972164405449220, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, language=EN, orderNo=4, keyword=External verification), Keyword(id=1240972164489335308, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, language=CN, orderNo=1, keyword=脑卒中患者), Keyword(id=1240972164594192916, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, language=CN, orderNo=2, keyword=卒中后疲劳), Keyword(id=1240972164707439137, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, language=CN, orderNo=3, keyword=预测模型), Keyword(id=1240972164816491051, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, language=CN, orderNo=4, keyword=外部验证)], refs=[Reference(id=1240972168423592675, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2021, volume=24, issue=17, pageStart=2214, pageEnd=2217, url=null, language=null, rfNumber=[1], rfOrder=0, authorNames=王梅杰, 邓雨芳, 周翔, journalName=中国全科医学, refType=null, unstructuredReference=王梅杰，邓雨芳，周翔，等.加拿大《最佳实践建议:卒中后抑郁、认知、疲劳》解读[J].中国全科医学，2021，24（17）：2214-2217., articleTitle=加拿大《最佳实践建议:卒中后抑郁、认知、疲劳》解读, refAbstract=null), Reference(id=1240972168570393322, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2021, volume=24, issue=17, pageStart=2214, pageEnd=2217, url=null, language=null, rfNumber=[1], rfOrder=1, authorNames=Wang MJ, Deng YF, Zhou X, journalName=Chinese General Practice, refType=null, unstructuredReference=Wang MJ, Deng YF, Zhou X, et al. Interpretation of the Canadian stroke best practice recommendations: mood, cognition and fatigue following stroke[J]. Chinese General Practice, 2021, 24(17): 2214-2217., articleTitle=Interpretation of the Canadian stroke best practice recommendations: mood, cognition and fatigue following stroke, refAbstract=null), Reference(id=1240972168704611056, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2022, volume=30, issue=7, pageStart=544, pageEnd=550, url=null, language=null, rfNumber=[2], rfOrder=2, authorNames=崔佩, 孙玉姣, 赵鑫, journalName=国际脑血管病杂志, refType=null, unstructuredReference=崔佩，孙玉姣，赵鑫，等.卒中后疲劳[J].国际脑血管病杂志，2022，30（7）：544-550., articleTitle=卒中后疲劳, refAbstract=null), Reference(id=1240972168855606011, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2022, volume=30, issue=7, pageStart=544, pageEnd=550, url=null, language=null, rfNumber=[2], rfOrder=3, authorNames=Cui P, Sun YJ, Zhao X, journalName=International Journal of Cerebrovascular Diseases, refType=null, unstructuredReference=Cui P, Sun YJ, Zhao X, et al. Post-stroke fatigue[J]. International Journal of Cerebrovascular Diseases, 2022, 30(7): 544-550., articleTitle=Post-stroke fatigue, refAbstract=null), Reference(id=1240972168985629445, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2021, volume=6, issue=4, pageStart=319, pageEnd=332, url=null, language=null, rfNumber=[3], rfOrder=4, authorNames=Alghamdi I, Ariti C, Williams A, journalName=Eur Stroke J, refType=null, unstructuredReference=Alghamdi I, Ariti C, Williams A, et al. Prevalence of fatigue after stroke: A systematic review and meta-analysis[J]. Eur Stroke J, 2021,6(4): 319-332., articleTitle=Prevalence of fatigue after stroke: A systematic review and meta-analysis, refAbstract=null), Reference(id=1240972169170178837, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2024, volume=38, issue=1, pageStart=7, pageEnd=18, url=null, language=null, rfNumber=[4], rfOrder=5, authorNames=English C, Simpson DB, Billinger SA, journalName=Neurorehabilitation and Neural Repair, refType=null, unstructuredReference=English C, Simpson DB, Billinger SA, et al. A roadmap for research in post-stroke fatigue: Consensus-based core recommendations from the third Stroke Recovery and Rehabilitation Roundtable[J].Neurorehabilitation and Neural Repair, 2024, 38(1): 7-18., articleTitle=A roadmap for research in post-stroke fatigue: Consensus-based core recommendations from the third Stroke Recovery and Rehabilitation Roundtable, refAbstract=null), Reference(id=1240972169329562401, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2023, volume=55, issue=5, pageStart=178, pageEnd=185, url=null, language=null, rfNumber=[5], rfOrder=6, authorNames=Paudel SK, Rolls K, Green H, journalName=The Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses, refType=null, unstructuredReference=Paudel SK, Rolls K, Green H, et al. Prevalence and impact of poststroke fatigue on patient outcomes in the first 6 months after stroke: a systematic review and meta-analysis[J]. The Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses, 2023, 55(5): 178-185., articleTitle=Prevalence and impact of poststroke fatigue on patient outcomes in the first 6 months after stroke: a systematic review and meta-analysis, refAbstract=null), Reference(id=1240972170923397935, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2020, volume=9, issue=null, pageStart=242, pageEnd=null, url=null, language=null, rfNumber=[6], rfOrder=7, authorNames=Aali G, Drummond A, das Nair R, journalName=F1000Research, refType=null, unstructuredReference=Aali G, Drummond A, das Nair R, et al.Post-stroke fatigue: a scoping review[J]. F1000Research, 2020, 9: 242., articleTitle=Post-stroke fatigue: a scoping review, refAbstract=null), Reference(id=1240972171112141625, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2015, volume=162, issue=1, pageStart=55, pageEnd=63, url=null, language=null, rfNumber=[7], rfOrder=8, authorNames=Collins GS, Reitsma JB, Altman DG, journalName=BMC Medicine, refType=null, unstructuredReference=Collins GS, Reitsma JB, Altman DG, et al. Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis(TRIPOD): the TRIPOD Statement[J]. BMC Medicine, 2015, 162(1):55-63., articleTitle=Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis(TRIPOD): the TRIPOD Statement, refAbstract=null), Reference(id=1240972171288302401, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2023, volume=21, issue=4, pageStart=139, pageEnd=143, url=null, language=null, rfNumber=[8], rfOrder=9, authorNames=高雅云, 林丽, journalName=中外医学研究, refType=null, unstructuredReference=高雅云， 林丽.脑卒中后疲劳列线图预测模型的构建及评估[J].中外医学研究，2023，21（4）：139-143., articleTitle=脑卒中后疲劳列线图预测模型的构建及评估, refAbstract=null), Reference(id=1240972171435103050, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2023, volume=21, issue=4, pageStart=139, pageEnd=143, url=null, language=null, rfNumber=[8], rfOrder=10, authorNames=Gao YY, Lin L, journalName=Chinese and Foreign Medical Research, refType=null, unstructuredReference=Gao YY, Lin L. Construction and verification of the nomogram prediction model of post-stroke fatigue[J]. Chinese and Foreign Medical Research,2023, 21(4): 139-143., articleTitle=Construction and verification of the nomogram prediction model of post-stroke fatigue, refAbstract=null), Reference(id=1240972171544154962, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2021, volume=30, issue=2, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[9], rfOrder=11, authorNames=Su Y, Yuki M, Hirayama K, journalName=Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association, refType=null, unstructuredReference=Su Y, Yuki M, Hirayama K, et al. Development and internal validation of a nomogram to predict Post-Stroke fatigue after discharge[J]. Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association, 2021, 30(2): 105484., articleTitle=Development and internal validation of a nomogram to predict Post-Stroke fatigue after discharge, refAbstract=null), Reference(id=1240972171636429661, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2021, volume=14, issue=1, pageStart=49, pageEnd=58, url=null, language=null, rfNumber=[10], rfOrder=12, authorNames=Ramspek CL, Jager KJ, Dekker FW, journalName=Clinical Kidney Journal, refType=null, unstructuredReference=Ramspek CL, Jager KJ, Dekker FW, et al. External validation of prognostic models: what, why, how, when and where?[J]. Clinical Kidney Journal, 2021, 14(1): 49-58., articleTitle=External validation of prognostic models: what, why, how, when and where?, refAbstract=null), Reference(id=1240972171779036004, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2019, volume=52, issue=9, pageStart=710, pageEnd=715, url=null, language=null, rfNumber=[11], rfOrder=13, authorNames=中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组, journalName=中华神经科杂志, refType=null, unstructuredReference=中华医学会神经病学分会， 中华医学会神经病学分会脑血管病学组.中国各类主要脑血管病诊断要点2019[J].中华神经科杂志，2019，52（9）：710-715., articleTitle=中国各类主要脑血管病诊断要点2019, refAbstract=null), Reference(id=1240972171900670830, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2019, volume=52, issue=9, pageStart=710, pageEnd=715, url=null, language=null, rfNumber=[11], rfOrder=14, authorNames=Chinese Society of Neurology, Chinese Stroke Society, journalName=Chin J Neurol, refType=null, unstructuredReference=Chinese Society of Neurology, Chinese Stroke Society. diagnostic criteria of cerebrovascular diseases in China(version 2019)[J]. Chin J Neurol, 2019, 52(9): 710-715., articleTitle=diagnostic criteria of cerebrovascular diseases in China(version 2019), refAbstract=null), Reference(id=1240972171980362618, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2017, volume=48, issue=7, pageStart=e159, pageEnd=e170, url=null, language=null, rfNumber=[12], rfOrder=15, authorNames=Hinkle JL, Becker KJ, Kim JS, journalName=Stroke, refType=null, unstructuredReference=Hinkle JL, Becker KJ, Kim JS, et al. Poststroke fatigue: emerging evidence and approaches to management: a scientific statement for healthcare professionals from the American heart association[J].Stroke, 2017, 48(7): e159-e170., articleTitle=Poststroke fatigue: emerging evidence and approaches to management: a scientific statement for healthcare professionals from the American heart association, refAbstract=null), Reference(id=1240972172072637312, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2023, volume=58, issue=1, pageStart=46, pageEnd=54, url=null, language=null, rfNumber=[13], rfOrder=16, authorNames=臧爽, 崔赢, 倪翠萍, journalName=中华护理杂志, refType=null, unstructuredReference=臧爽，崔赢，倪翠萍，等.卒中后疲劳评估工具的范围综述[J].中华护理杂志，2023，58（1）：46-54., articleTitle=卒中后疲劳评估工具的范围综述, refAbstract=null), Reference(id=1240972172202660742, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2023, volume=58, issue=1, pageStart=46, pageEnd=54, url=null, language=null, rfNumber=[13], rfOrder=17, authorNames=Zang S, Cui Y, Ni CP, journalName=Chinese Journal of Nursing, refType=null, unstructuredReference=Zang S, Cui Y, Ni CP, et al. A scoping review of assessment tools for post-stroke fatigue[J]. Chinese Journal of Nursing, 2023, 58(1): 46-54., articleTitle=A scoping review of assessment tools for post-stroke fatigue, refAbstract=null), Reference(id=1240972172332684174, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2022, volume=17, issue=10, pageStart=1491, pageEnd=1495, url=null, language=null, rfNumber=[14], rfOrder=18, authorNames=陈擘璨, 吴孝文, 陈友红, journalName=中国医药, refType=null, unstructuredReference=陈擘璨， 吴孝文， 陈友红.急性缺血性脑卒中患者血清可溶性细胞黏附分子水平变化及其与卒中后疲劳的关系[J].中国医药，2022，17（10）：1491-1495., articleTitle=急性缺血性脑卒中患者血清可溶性细胞黏附分子水平变化及其与卒中后疲劳的关系, refAbstract=null), Reference(id=1240972172420764560, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2022, volume=17, issue=10, pageStart=1491, pageEnd=1495, url=null, language=null, rfNumber=[14], rfOrder=19, authorNames=Chen BC, Wu XW, Chen YH, journalName=China Medicine, refType=null, unstructuredReference=Chen BC, Wu XW, Chen YH. Changes of serum soluble cellular adhesion molecule levels in patients with acute ischemic stroke and their relationship with post-stroke fatigue[J]. China Medicine, 2022, 17(10):1491-1495., articleTitle=Changes of serum soluble cellular adhesion molecule levels in patients with acute ischemic stroke and their relationship with post-stroke fatigue, refAbstract=null), Reference(id=1240972172500456341, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2021, volume=28, issue=17, pageStart=64, pageEnd=69, url=null, language=null, rfNumber=[15], rfOrder=20, authorNames=吴巧娣, 周静, 王硕, journalName=护理学报, refType=null, unstructuredReference=吴巧娣， 周静， 王硕.康复自我效能在老年脑卒中康复期患者卒中后抑郁与卒中后疲劳间的中介效应[J].护理学报，2021，28（17）：64-69., articleTitle=康复自我效能在老年脑卒中康复期患者卒中后抑郁与卒中后疲劳间的中介效应, refAbstract=null), Reference(id=1240972172634674075, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2021, volume=28, issue=17, pageStart=64, pageEnd=69, url=null, language=null, rfNumber=[15], rfOrder=21, authorNames=Wu QD, Zhou J, Wang S, journalName=Journal of Nursing, refType=null, unstructuredReference=Wu QD, Zhou J, Wang S. Mediation effect of rehabilitation self-efficacy between post-stroke depression and post-stroke fatigue in elderly patients recovering from stroke[J]. Journal of Nursing, 2021, 28(17): 64-69., articleTitle=Mediation effect of rehabilitation self-efficacy between post-stroke depression and post-stroke fatigue in elderly patients recovering from stroke, refAbstract=null), Reference(id=1240972172760503201, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2024, volume=27, issue=3, pageStart=364, pageEnd=374, url=null, language=null, rfNumber=[16], rfOrder=22, authorNames=薛超, 李娟, 方茜, journalName=中国全科医学, refType=null, unstructuredReference=薛超，李娟，方茜，等.中国卒中后疲劳患病率及发展趋势的Meta分析[J].中国全科医学，2024，27（3）：364-374., articleTitle=中国卒中后疲劳患病率及发展趋势的Meta分析, refAbstract=null), Reference(id=1240972172903109546, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2024, volume=27, issue=3, pageStart=364, pageEnd=374, url=null, language=null, rfNumber=[16], rfOrder=23, authorNames=Xue C, Li J, Fang Q, journalName=Chinese General Practice, refType=null, unstructuredReference=Xue C, Li J, Fang Q, et al. Prevalence and trends for post-stroke fatigue in China:a meta-analysis[J]. Chinese General Practice, 2024, 27(3): 364-374., articleTitle=Prevalence and trends for post-stroke fatigue in China:a meta-analysis, refAbstract=null), Reference(id=1240972173020550067, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2022, volume=32, issue=1, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[17], rfOrder=24, authorNames=Coletti C, Acosta GF, Keslacy S, journalName=European Journal of Translational Myology, refType=null, unstructuredReference=Coletti C, Acosta GF, Keslacy S, et al. Exercise-mediated reinnervation of skeletal muscle in elderly People: An update[J].European Journal of Translational Myology, 2022, 32(1): 10416., articleTitle=Exercise-mediated reinnervation of skeletal muscle in elderly People: An update, refAbstract=null), Reference(id=1240972173251236793, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2021, volume=34, issue=3, pageStart=223, pageEnd=226, url=null, language=null, rfNumber=[18], rfOrder=25, authorNames=任思强, 张茜, 代玉玺, journalName=临床神经病学杂志, refType=null, unstructuredReference=任思强，张茜，代玉玺，等.脑卒中后疲劳发病机制及影响因素的研究进展[J].临床神经病学杂志，2021，34（3）：223-226., articleTitle=脑卒中后疲劳发病机制及影响因素的研究进展, refAbstract=null), Reference(id=1240972173377065921, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2021, volume=34, issue=3, pageStart=223, pageEnd=226, url=null, language=null, rfNumber=[18], rfOrder=26, authorNames=Ren SQ, Zhang Q, Dai YX, journalName=Journal of Clinical Neurology, refType=null, unstructuredReference=Ren SQ, Zhang Q, Dai YX, et al. Research progress on the pathogenesis and influencing factors of physical fatigue after stroke[J]. Journal of Clinical Neurology, 2021, 34(3): 223-226., articleTitle=Research progress on the pathogenesis and influencing factors of physical fatigue after stroke, refAbstract=null), Reference(id=1240972173553226695, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2022, volume=22, issue=1, pageStart=316, pageEnd=null, url=null, language=null, rfNumber=[19], rfOrder=27, authorNames=Binuya MAE, Engelhardt EG, Schats W, journalName=BMC Medical Research Methodology, refType=null, unstructuredReference=Binuya MAE, Engelhardt EG, Schats W, et al. Methodological guidance for the evaluation and updating of clinical prediction models: a systematic review[J]. BMC Medical Research Methodology,2022, 22(1): 316., articleTitle=Methodological guidance for the evaluation and updating of clinical prediction models: a systematic review, refAbstract=null), Reference(id=1240972173708415953, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2017, volume=318, issue=14, pageStart=1377, pageEnd=1384, url=null, language=null, rfNumber=[20], rfOrder=28, authorNames=Alba AC, Agoritsas T, Walsh M, journalName=JAMA : the Journal of the American Medical Association, refType=null, unstructuredReference=Alba AC, Agoritsas T, Walsh M, et al. Discrimination and calibration of clinical prediction models: users' guides to the medical literature[J]. JAMA : the Journal of the American Medical Association, 2017, 318(14): 1377-1384., articleTitle=Discrimination and calibration of clinical prediction models: users' guides to the medical literature, refAbstract=null), Reference(id=1240972173846827987, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2020, volume=1, issue=8, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[21], rfOrder=29, authorNames=Ho SY, Phua K, Wong L, journalName=Patterns (N Y), refType=null, unstructuredReference=Ho SY, Phua K, Wong L, et al. Extensions of the external validation for checking learned model interpretability and generalizability[J].Patterns (N Y), 2020, 1(8): 100129., articleTitle=Extensions of the external validation for checking learned model interpretability and generalizability, refAbstract=null), Reference(id=1240972175369360347, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2020, volume=8, issue=4, pageStart=74, pageEnd=null, url=null, language=null, rfNumber=[22], rfOrder=30, authorNames=Han QY, Hu ZD, journalName=Ann Transl Med, refType=null, unstructuredReference=Han QY, Hu ZD. Clinical prediction model construction and evaluation: a challenge for clinical researchers[J]. Ann Transl Med,2020, 8(4): 74., articleTitle=Clinical prediction model construction and evaluation: a challenge for clinical researchers, refAbstract=null), Reference(id=1240972175470023645, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, doi=null, pmid=null, pmcid=null, year=2021, volume=21, issue=10, pageStart=1643, pageEnd=1648, url=null, language=null, rfNumber=[23], rfOrder=31, authorNames=Vickers AJ, Holland F, journalName=The Spine Journal, refType=null, unstructuredReference=Vickers AJ, Holland F. Decision curve analysis to evaluate the clinical benefit of prediction models[J]. The Spine Journal, 2021, 21(10): 1643-1648., articleTitle=Decision curve analysis to evaluate the clinical benefit of prediction models, refAbstract=null)], funds=[Fund(id=1240972167832195771, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, awardId=GXZYA 20220065, language=CN, fundingSource=广西壮族自治区中医药管理局自筹经费科研课题(GXZYA 20220065), fundOrder=null, country=null), Fund(id=1240972167966413511, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, awardId=2022A010, language=CN, fundingSource=广西中医药大学高层次人才培育创新团队建设项目(2022A010), fundOrder=null, country=null), Fund(id=1240972168155157202, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, awardId=2023BS055, language=CN, fundingSource=广西中医药大学引进博士科研启动基金项目(2023BS055), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1240972162396377422, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, xref=null, ext=[AuthorCompanyExt(id=1240972162408960335, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, companyId=1240972162396377422, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Guangxi University of Chinese Medicine, Nanning, Guangxi 530200, China), AuthorCompanyExt(id=1240972162421543248, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, companyId=1240972162396377422, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=广西中医药大学，广西 南宁 530200)])], figs=[ArticleFig(id=1240972166490018369, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, language=EN, label=Figure 1, caption=PSF nomogram prediction model, figureFileSmall=m7JoXB4UNFb5hpWtouhsxw==, figureFileBig=J2NzZ/uKjetkc4hCVdwViQ==, tableContent=null), ArticleFig(id=1240972166573904458, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, language=CN, label=图1, caption=PSF列线图预测模型, figureFileSmall=m7JoXB4UNFb5hpWtouhsxw==, figureFileBig=J2NzZ/uKjetkc4hCVdwViQ==, tableContent=null), ArticleFig(id=1240972166737482325, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, language=EN, label=Figure 2, caption=ROC curves of external validation of two PSF risk prediction models, figureFileSmall=Q+5I6/kshxkDVBCj++lCjg==, figureFileBig=tq+cTdxz7gxiEgs8VTvtiw==, tableContent=null), ArticleFig(id=1240972166854922852, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, language=CN, label=图2, caption=两种PSF风险预测模型外部验证的ROC曲线, figureFileSmall=Q+5I6/kshxkDVBCj++lCjg==, figureFileBig=tq+cTdxz7gxiEgs8VTvtiw==, tableContent=null), ArticleFig(id=1240972166968169070, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, language=EN, label=Figure 3, caption=DCA of two PSF risk prediction models, figureFileSmall=Khy/pDYHFa4ACQ7JVxYnTg==, figureFileBig=kDfKoysLK/hze4MFicX7DA==, tableContent=null), ArticleFig(id=1240972167060443768, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, language=CN, label=图3, caption=两种PSF风险预测模型的DCA, figureFileSmall=Khy/pDYHFa4ACQ7JVxYnTg==, figureFileBig=kDfKoysLK/hze4MFicX7DA==, tableContent=null), ArticleFig(id=1240972167165301383, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, language=EN, label=Table 1, caption=

Comparison of general data between two groups of patients ［（）, n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
项目PSF组
(n=128)		NPSF组
(n=145)		χ2/t值P值
年龄（岁）69.79±11.4365.30±9.643.523<0.001
性别0.6330.426
男77(60.16)94(64.83)
女51(39.84)51(35.17)
急性期疲劳78(60.94)26(17.93)48.491<0.001
吞咽困难53(41.41)30(20.69)13.378<0.001
抑郁状态39(30.47)34(23.45)1.7030.192
卒中后疼痛34(26.56)33(22.76)0.5300.466
高血压病史91(71.09)96(66.21)0.7510.386
糖尿病病史60(46.88)38(26.21)12.356<0.001
既往卒中史62(48.44)38(26.21)14.134<0.001
卒中前骨骼肌减少症39(30.47)12(8.28)19.554<0.001
), ArticleFig(id=1240972167278547598, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, language=CN, label=表1, caption=

两组患者一般资料比较［（）, n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
项目PSF组
(n=128)		NPSF组
(n=145)		χ2/t值P值
年龄（岁）69.79±11.4365.30±9.643.523<0.001
性别0.6330.426
男77(60.16)94(64.83)
女51(39.84)51(35.17)
急性期疲劳78(60.94)26(17.93)48.491<0.001
吞咽困难53(41.41)30(20.69)13.378<0.001
抑郁状态39(30.47)34(23.45)1.7030.192
卒中后疼痛34(26.56)33(22.76)0.5300.466
高血压病史91(71.09)96(66.21)0.7510.386
糖尿病病史60(46.88)38(26.21)12.356<0.001
既往卒中史62(48.44)38(26.21)14.134<0.001
卒中前骨骼肌减少症39(30.47)12(8.28)19.554<0.001
), ArticleFig(id=1240972167421153946, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, language=EN, label=Table 2, caption=

Results of related prediction indicators of two PSF risk prediction models

, figureFileSmall=null, figureFileBig=null, tableContent=
模型AUC（95%CI）P值临界值灵敏度特异度准确度阳性预测值阴性预测值约登指数
列线图0.687（0.624～0.749）<0.0010.5920.5000.7930.6370.6330.6400.293
Web计算器程序0.743（0.683～0.803）<0.0010.4380.6090.8070.7140.7360.7010.416
), ArticleFig(id=1240972167626674859, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950903231017722, language=CN, label=表2, caption=

两种PSF风险预测模型的相关预测指标结果

, figureFileSmall=null, figureFileBig=null, tableContent=
模型AUC（95%CI）P值临界值灵敏度特异度准确度阳性预测值阴性预测值约登指数
列线图0.687（0.624～0.749）<0.0010.5920.5000.7930.6370.6330.6400.293
Web计算器程序0.743（0.683～0.803）<0.0010.4380.6090.8070.7140.7360.7010.416
)], attaches=null, journal=Journal(id=1227664546253402114, delFlag=0, nameCn=现代预防医学, nameEn=Modern Preventive Medicine, nameHistory1=null, nameHistory2=null, issn=1003-8507, eissn=null, cn=51-1365/R, coden=null, periodic=3, language=CN, oaType=null, ccby=null, superviseOffice=null, ownerOffice=null, pubOffice=null, editorOffice=null, officeType=null, aims=null, clcCode=null, officeProv=null, officeCity=null, officeAddr=null, officeZip=null, officeEmail=null, officePhone=null, editDirector=null, officeDirector=null, officeDirectorPhone=null, officeStaffNum=null, officeEmpNum=null, coverPicUrl=IeiuPXEZi6AA+k0VfvoiOQ==, journalPrice=null, startedYear=null, abbrevIsoEn=Modern Preventive Medicine, journalRemark=null, publicationField=null, createdTime=1770627636734, updatedTime=1770628902248, createdBy=18614031015, updatedBy=13701087609, firstLetterCn=M, firstLetterEn=M, subjectCode=Life Sciences, subjectName=null, subjectCodeEn=Life Sciences, subjectNameEn=null, picCn=IeiuPXEZi6AA+k0VfvoiOQ==, picEn=/9iTl8/ndms4tBz1fL28Pg==, jcr=null, cjcr=null, exts=[JournalExt(id=1227669854342280188, language=CN, name=现代预防医学, nameHistory1=null, nameHistory2=null, managedBy=, sponsoredBy=, publishedBy=, editorOffice=, officeProv=null, officeCity=null, officeAddr=, officeZip=, editDirector=, officeDirector=null, officePhone=null, coverPicUrl=null, journalRemark=, submitArticleUrl=null, websiteUrl=, createdTime=1770628902278, updatedTime=1770628902278, createdBy=13701087609, updatedBy=13701087609, submissionGuidelinesUrl=, submissionAuthorUrl=http://xdyfyxzz.paperopen.com/#/regist, submissionEditorUrl=http://xdyfyxzz.paperopen.com/#/Login, submissionReviewUrl=http://xdyfyxzz.paperopen.com/#/Login, submissionCeEditorUrl=, submissionAeEditorUrl=, option={"copyright":""}), JournalExt(id=1227669854396806141, language=EN, name=Modern Preventive Medicine, nameHistory1=null, nameHistory2=null, managedBy=, sponsoredBy=, publishedBy=, editorOffice=, officeProv=null, officeCity=null, officeAddr=, officeZip=, editDirector=, officeDirector=null, officePhone=null, coverPicUrl=null, journalRemark=, submitArticleUrl=null, websiteUrl=, createdTime=1770628902291, updatedTime=1770628902291, createdBy=13701087609, updatedBy=13701087609, submissionGuidelinesUrl=, submissionAuthorUrl=http://xdyfyxzz.paperopen.com/#/regist, submissionEditorUrl=http://xdyfyxzz.paperopen.com/#/Login, submissionReviewUrl=http://xdyfyxzz.paperopen.com/#/Login, submissionCeEditorUrl=, submissionAeEditorUrl=, option={"copyright":""})], databaseList=null, tenantJournalId=1227665162245664772, websiteList=[Website(id=1227687234141352800, webName=null, webTitle=null, webDomain=null, webCopyrigh=null, webIpcNo=null, seoTitle=null, seoKeywords=null, seoDescription=null, tenantJournalId=null, journalId=1227665162245664772, journalNameCn=null, journalNameEn=null, grayFlag=null, tenantId=1146029695717560320, platformId=null, journalGroupId=null, journalGroupNameCn=null, journalGroupNameEn=null, type=1, domain=https://castjournals.cast.org.cn/joweb/xdyfyx/CN, language=CN, createTime=1770633045945, createBy=18614031015, updateTime=1770633090526, updateBy=18614031015, name=现代预防医学-中文, tplId=1146099689490845704, title=现代预防医学, delFlag=0, indexPage=/home, props=[WebsiteProps(id=1227687735088051072, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=articleTextType, value=kx, createTime=1770633165380, updateTime=1770633165380, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735071273853, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=banner, value=null, createTime=1770633165376, updateTime=1770633165376, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735113216899, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=grayFlag, value=0, createTime=1770633165386, updateTime=1770633165386, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735062885244, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=logo, value=https://castjournals.cast.org.cn/joweb/xdyfyx/CN/file/pic?fileId=/XB5plC0xuykmQnycvtyrw==, createTime=1770633165374, updateTime=1770633165374, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735125799813, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=minRunFlag, value=0, createTime=1770633165389, updateTime=1770633165389, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735083856767, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=picServerUrl, value=https://castjournals.cast.org.cn/joweb/xdyfyx/CN/file/pic, createTime=1770633165379, updateTime=1770633165379, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735121605508, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=silenceFlag, value=0, createTime=1770633165388, updateTime=1770633165388, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735079662462, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=staticResourcePath, value=https://castjournals.cast.org.cn/joweb/cast_kjdb_cn_619/, createTime=1770633165378, updateTime=1770633165378, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735096439681, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=themeColor, value=null, createTime=1770633165382, updateTime=1770633165382, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687735104828290, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234141352800, code=themeStyle, value=null, createTime=1770633165384, updateTime=1770633165384, creator=18614031015, updator=18614031015)]), Website(id=1227687234338485094, webName=null, webTitle=null, webDomain=null, webCopyrigh=null, webIpcNo=null, seoTitle=null, seoKeywords=null, seoDescription=null, tenantJournalId=null, journalId=1227665162245664772, journalNameCn=null, journalNameEn=null, grayFlag=null, tenantId=1146029695717560320, platformId=null, journalGroupId=null, journalGroupNameCn=null, journalGroupNameEn=null, type=1, domain=https://castjournals.cast.org.cn/joweb/xdyfyx/EN, language=EN, createTime=1770633045992, createBy=18614031015, updateTime=1770633115374, updateBy=18614031015, name=现代预防医学-英文, tplId=1146101810881728533, title=Modern Preventive Medicine, delFlag=0, indexPage=/home, props=[WebsiteProps(id=1227687709129507332, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=articleTextType, value=kx, createTime=1770633159191, updateTime=1770633159191, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709108535809, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=banner, value=null, createTime=1770633159186, updateTime=1770633159186, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709167256071, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=grayFlag, value=0, createTime=1770633159200, updateTime=1770633159200, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709095952896, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=logo, value=https://castjournals.cast.org.cn/joweb/xdyfyx/EN/file/pic?fileId=/XB5plC0xuykmQnycvtyrw==, createTime=1770633159183, updateTime=1770633159183, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709179838985, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=minRunFlag, value=0, createTime=1770633159203, updateTime=1770633159203, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709121118723, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=picServerUrl, value=https://castjournals.cast.org.cn/joweb/xdyfyx/EN/file/pic, createTime=1770633159189, updateTime=1770633159189, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709171450376, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=silenceFlag, value=0, createTime=1770633159201, updateTime=1770633159201, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709112730114, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=staticResourcePath, value=https://castjournals.cast.org.cn/joweb/cast_kjdb_en_623/, createTime=1770633159187, updateTime=1770633159187, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709133701637, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=themeColor, value=null, createTime=1770633159192, updateTime=1770633159192, creator=18614031015, updator=18614031015), WebsiteProps(id=1227687709154673158, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1227687234338485094, code=themeStyle, value=null, createTime=1770633159197, updateTime=1770633159197, creator=18614031015, updator=18614031015)])], journalTitle=现代预防医学, weixinUrl=null, journalUrl=http://xdyfyxzz.paperopen.com/, iacademicId=null, status=1, seqNo=null, journalTitleEn=Modern Preventive Medicine, journalPhotoCn=IeiuPXEZi6AA+k0VfvoiOQ==, journalPhotoEn=/9iTl8/ndms4tBz1fL28Pg==, journalFirstLetter=M, journalRecommend=null, journalNew=null, journalCollection=null, jcrJf=null, cjcrJf=null, jcrJfStr=null, cjcrJfStr=null, submissionFirstDecision=null, sciSubjectClassification=null, casSubjectClassification=null, citeScore=null, totalCitationFrequency=null, icpCode=null, psCode=null, advertisingLicenseCode=null, copyrightInformation=null, country=null, option=, provinceCode=null, provinceName=null, collectFlag=false), detailUrlCn=https://castjournals.cast.org.cn/joweb/xdyfyx/CN/10.20043/j.cnki.MPM.202307262, detailUrlEn=https://castjournals.cast.org.cn/joweb/xdyfyx/EN/10.20043/j.cnki.MPM.202307262, pdfUrlCn=https://castjournals.cast.org.cn/joweb/xdyfyx/CN/PDF/10.20043/j.cnki.MPM.202307262, pdfUrlEn=https://castjournals.cast.org.cn/joweb/xdyfyx/EN/PDF/10.20043/j.cnki.MPM.202307262, aliStartDate=null, aliEndDate=null, collectionFlag=false, citedCount=null, citedUrl=null, reference=null)
收藏切换
两种预测模型在脑卒中患者卒中后疲劳风险预测中的应用价值比较
收藏切换
PDF下载
杨金盘 , 马秋平 , 刘裕君 , 张佳琳
现代预防医学 | 流行病与统计方法 2024,51(7): 1161-1165
收起
收藏切换
现代预防医学 | 流行病与统计方法 2024, 51(7): 1161-1165
两种预测模型在脑卒中患者卒中后疲劳风险预测中的应用价值比较
全屏
杨金盘, 马秋平 , 刘裕君, 张佳琳
作者信息
  • 广西中医药大学，广西 南宁 530200

    • 杨金盘（1994—），男，硕士在读，研究方向：老年常见疾病的防治

通讯作者:

马秋平，E-mail:
Comparison of the application value of two prediction models in the prediction of post-stroke fatigue risk in stroke patients
Jin-pan YANG, Qiu-ping MA , Yu-jun LIU, Jia-lin ZHANG
Affiliations
  • Guangxi University of Chinese Medicine, Nanning, Guangxi 530200, China
出版时间: 2024-04-10 doi: 10.20043/j.cnki.MPM.202307262
文章导航
收藏切换
摘要
收起
目的

探讨并比较分析脑卒中后疲劳(post-stroke fatigue, PSF)风险预测列线图和Web计算器程序在脑卒中恢复期患者PSF风险预测中的应用价值。

方法

前瞻性选取某家三甲医院脑病科2023年2—8月收治的急性期卒中患者，使用列线图和Web计算器程序预测每位卒中患者未来在恢复期发生PSF的风险概率。应用受试者工作特征曲线下面积(area under curve, AUC)、Hosmer-Lemeshow拟合优度检验、临床决策曲线分别评价两种模型的区分度、校准度和临床效用。

结果

共纳入282例卒中患者，其中128例发生PSF，PSF发生率为46.89%。列线图和Web计算器程序的AUC分别为0.687(95%CI: 0.624～0.749)、0.743(95%CI: 0.683～0.803)。Hosmer-Lemeshow拟合优度检验提示，列线图(χ2=8.357，P=0.213)和Web计算器程序(χ2=4.467，P=0.614)在卒中患者中的拟合度良好。临床决策曲线分析显示，列线图和Web计算器程序分别在阈概率0.35～0.81、0.33～0.88范围内有临床获益。

结论

列线图和Web计算器程序能有效预测卒中恢复期患者的PSF风险，Web计算器程序优于列线图。但未来Web计算器程序模型仍需进一步更新以平衡简便性和准确性，进而提高其临床适用性。

脑卒中患者  /  卒中后疲劳  /  预测模型  /  外部验证
Objective

To explore and compare the application value of post-stroke fatigue (PSF) risk prediction nomogram and Web calculator program in post-stroke fatigue risk prediction in convalescent stroke patients.

Methods

The patients with acute stroke admitted to the Department of Encephalopathy of a tertiary hospital from February 2023 to August 2023 were prospectively selected, and the nomogram and Web calculator program were used to predict the risk probability of PSF in convalescent stage. The area under the receiver operating characteristic curve (AUC), Hosmer-Lemeshow goodness-of-fit test, and clinical decision curve were used to evaluate the discrimination, calibration, and clinical utility of the two models, respectively.

Results

A total of 282 patients were included, of which 128 had PSF, and the incidence of PSF was 46.89%. The AUC of the nomogram and Web calculator were 0.687 (95%CI:0.624-0.749) and 0.743 (95%CI: 0.683-0.803), respectively. The Hosmer-Lemeshow goodness-of-fit test showed that the nomogram (χ2=8.357, P=0.213) and Web calculator program (χ2=4.467, P=0.614) were well fitted in stroke patients. The clinical decision curve analysis showed that the nomogram and Web calculator program had clinical benefits in the range of threshold probability of 0.35-0.81 and 0.33-0.88, respectively.

Conclusion

The nomogram and Web calculator program can effectively predict the PSF risk of stroke convalescent patients, and the Web calculator program is superior to the nomogram. However, the future Web calculator program model still needs to be further updated to balance simplicity and accuracy, thereby improving its clinical applicability.

Stroke patients  /  Post stroke fatigue  /  Predictive model  /  External verification
杨金盘, 马秋平, 刘裕君, 张佳琳. 两种预测模型在脑卒中患者卒中后疲劳风险预测中的应用价值比较. 现代预防医学, 2024 , 51 (7) : 1161 -1165 . DOI: 10.20043/j.cnki.MPM.202307262
Jin-pan YANG, Qiu-ping MA, Yu-jun LIU, Jia-lin ZHANG. Comparison of the application value of two prediction models in the prediction of post-stroke fatigue risk in stroke patients[J]. Modern Preventive Medicine, 2024 , 51 (7) : 1161 -1165 . DOI: 10.20043/j.cnki.MPM.202307262
正文
收起
脑卒中后疲劳(post-stroke fatigue, PSF)是一种多维的持续性运动知觉、情感和认知体验综合征[1]，多表现为经休息后不能缓解且持续存在的病理性疲劳感[2]。PSF是卒中患者常见的并发症之一，其总体患病率为48%[3]，可严重影响卒中患者的康复依从性[4]和生活质量[5]，甚至增加其死亡风险[6]。开展PSF早期风险评估，识别PSF高危患者，是降低PSF发病率的关键环节。PSF风险预测模型是以PSF的多病因为基础，构建并利用数理模型来预测卒中患者未来发生PSF的概率[7]。目前，高雅云等[8]和Su等[9]学者利用logistic回归分别构建了PSF风险预测列线图和Web计算器程序，内部验证受试者工作特征曲线下面积(area under curve, AUC)分别为0.711、0.762，具有良好的区分度。但上述两种预测模型均未进行外部验证，故尚无法评估其可移植性和可泛化性，影响其临床应用。使用不同于建模时所用的新数据集对模型进行外部验证和对现有模型进行比较是必要的[10]。预测模型国际规范指南[7]也指出，不推荐未经外部验证的预测模型用于临床实践。因此，本研究同时使用列线图和Web计算器程序对卒中恢复期患者的PSF发生风险进行预测，探讨两种模型在新数据集中的预测性能，比较两种模型的优劣，以期为模型的推广应用提供实践基础。
1　资料与方法
收起
1.1　研究设计类型
本研究为前瞻性、观察性研究。
1.2　研究对象
采用目的抽样法，选取某三甲医院脑病科2023年2—8月收治的经头颅MRI或CT证实为脑卒中的282例卒中患者为研究对象。诊断标准符合《中国各类主要脑血管病诊断要点2019》[11]。纳入标准：（1）年龄≥18周岁；（2）知情同意，自愿参与本研究；（3）发病时间≤14日。排除标准：（1）脑卒中前已发生疲劳；（2）卒中前3个月内有抑郁病史；（3）存在严重听力、视觉、沟通、认知障碍者，或存在严重瘫痪者，不能配合完成可信的调查及量表评定者；（4）既往有睡眠障碍、免疫系统疾病、造血系统疾病、肿瘤病史，合并严重疾病者；（5）病历资料不完整或随访期失访者。本研究严格依据《赫尔辛基宣言》规定的指导方针进行，经广西中医药大学第一附属医院医学伦理委员会（GXZYA2022-031-01）同意，所有研究对象均自愿参与并签署了纸质版知情同意书。
1.3　研究工具
（1）PSF影响因素调查问卷由研究者自行设计，包括高血压病史、既往卒中史等一般资料和年龄、性别、急性期疲劳、吞咽困难、抑郁状态、卒中后疼痛、糖尿病、卒中前骨骼肌减少症等模型预测因子。（2）PSF风险预测列线图[8]以列线图为模型呈现方式，包括年龄、糖尿病、抑郁状态、卒中后疼痛四个预测因子，见图1。内部验证显示，该模型的AUC为0.711(95%CI: 0.645～0.778)。（3）PSF风险预测Web计算器程序[9]是一种电脑Web程序，通过登录https://yasu2020.shinyapps.io/dynnomapp/，在线输入相关信息即可获得卒中患者的PSF风险值，该模型包括性别、急性期疲劳、吞咽困难、抑郁状态、卒中前骨骼肌减少症五个预测因子。内部验证显示，该模型的C-index为0.801(95%CI: 0.700～0.902)，区间验证模型C-index为0.762。（4）疲劳严重程度量表(fatigue severity scale, FSS)是美国心脏协会心血管和卒中护理委员会及卒中委员会[12]推荐使用的疲劳评估量表。FSS量表总均分为7分，≥4分为疲劳，得分越高，疲劳越严重，经汉化后的Cronbach α系数为0.929[13]，在筛选PSF方面表现出良好的信度。
1.4　资料收集方法
本研究依据两种模型中的预测因子自行设计调查问卷，由经过培训的研究者于卒中患者在院期间，利用HIS电子病历系统和纸质文书收集模型中各个预测因子数据，代入相应模型得出该卒中患者在恢复期发生PSF的概率值。随访观察3个月，在卒中患者恢复期，由经过培训的研究者使用FSS量表评估卒中患者发病3个月后的疲劳状况（FSS得分）。专人进行数据录入，第二名研究者进行统计分析。
1.5　统计学方法
用SPSS 26.0软件进行统计分析，正态分布计量资料用（）标准差表示，组间比较采用t检验；非正态分布计量资料采用［M（P25，P75）］表示，组间比较采用秩和检验；计数资料用［n（%）］表示，组间比较采χ2检验。采用1 000次Bootstrap自抽样法对模型进行外部验证。使用R 4.1.2软件的pROC包绘制并计算模型的受试者工作特征(receiver operating characteristic, ROC)曲线和AUC、临界值、灵敏度、特异度、准确度、阳性预测值、阴性预测值、约登指数；采用DeLong法对两种模型的AUC进行比较，评估模型间预测能力有无差异；使用rms包绘制模型的校准曲线，采用Homser-Lemeshow拟合优度检验评价模型的校准度；使用rmda包计算并绘制模型的临床决策曲线分析(decision curve analysis, DCA)图。采用双侧检验，检验水准α=0.05。
2　结果
收起
2.1　研究对象一般资料
本研究共纳入282例卒中患者，9例卒中患者因死亡、并发重症肌无力、罹患癌症等原因失访，最终共273例进行分析，PSF发生率为46.89%。其中，男171例，女102例；年龄为(67.40±10.73)岁。一般资料比较显示，PSF组患者急性期疲劳、吞咽困难、糖尿病、既往卒中史、卒中前骨骼肌减少症比例及Age水平均高于NPSF组(P<0.05)；而性别、抑郁状态、卒中后疼痛、高血压比例两组间比较，差异无统计学意义（P>0.05）。见表1。
2.2　模型区分度
采用ROC曲线对两种模型的区分度进行外部验证。列线图和Web计算器程序在外部验证人群中的AUC分别为0.687(95%CI: 0.624～0.749)和0.743(95%CI: 0.683～0.803)，采用DeLong法对两种模型AUC值进行比较，结果显示两者相较差异无统计学意义(Z=1.531，P=0.126>0.05)。列线图的最大约登指数为0.293，最佳临界值为0.592，灵敏度和特异度分别为0.500、0.793；Web计算器程序的最大约登指数为0.416，最佳临界值为0.438，灵敏度和特异度分别为0.609、0.807。见图2、表2。
2.3　模型校准度
采用Hosmer-Lemeshow拟合优度检验评价两种模型的校准能力。Hosmer-Lemeshow拟合优度检验结果显示，列线图的预测概率和实际概率无明显差异(χ2=8.357，P=0.213>0.05)；Web计算器程序的预测概率和实际概率无明显差异(χ2=4.467，P=0.614>0.05)，提示列线图和Web计算器程序在卒中患者中的拟合度良好。经外部验证结果显示，Web计算器程序相较于列线图在预测卒中恢复期患者发生PSF方面呈现出更好的校准能力。
2.4　模型的临床效用
使用R 4.1.2软件的rmda包计算并绘制两种模型的DCA图。“None”表示纳入的卒中患者均为NPSF且未进行临床干预治疗，净获益为0；“All”表示纳入的卒中患者均为PSF且均接受了临床干预治疗，净获益为斜率是负值的反斜线，这2条线界定了模型阈概率和净获益范围。在阈概率0.35～0.81范围内，列线图的净获益高于“None”和“All”；在阈概率0.33～0.88范围内，Web计算器程序的净获益高于列线图、“None”及“All”，提示两种模型均具有一定的临床获益，且Web计算器程序有更宽的阈概率和更大的净获益。见图3。
3　讨论
收起
3.1　卒中患者发生PSF的风险较高
本研究中，卒中恢复期患者PSF发生率为46.89%，与陈擘璨等[14]的研究结果基本一致，低于吴巧娣等[15]报告的51.40%，可能与本研究对象的卒中病程时间(14～90 d)短于吴巧娣等[15]的3.00(0.00～8.00)年有关。但与既往研究[16]结果（23.3%～74.2%）相比，仍处于中等偏高水平。究其原因，本研究卒中患者年龄［（67.40±10.73）岁］较大，机体存在退行性病变，骨骼肌含量、强度及功能的下降可降低其活动耐力[17]，同时卒中患者更易发生神经内分泌紊乱和持续的低激素水平进而加重疲劳症状[18]。因此，卒中恢复期患者具有较高的PSF发生率，提示医护人员需早期评估PSF发生风险并进行干预，以期预防PSF的发生和减少其对卒中患者预后康复的影响。
3.2　两种PSF风险预测模型具有中等程度的预测性能
模型外部验证主要考察的是区分度、校准度[19]。区分度是反映模型区分能力的指标，AUC在0.60～0.75为中区分度[20]。校准度可反映模型的绝对风险预测值是否准确，即模型预测概率与实际发生概率的一致程度[19]，常以Hosmer-Lemeshow拟合优度检验P>0.05表示校准度良好。本研究外部验证显示，列线图和Web计算器程序的AUC分别为0.687、0.743，相比内部验证，区分度有所下降，但仍均>0.6，表明模型具有中等程度的区分度。本研究Hosmer-Lemeshow拟合优度检验结果显示，两种模型的预测值和实际观测值间的差异较小(P>0.05)，表明两种模型的风险预测准确性较高，校准度良好。然而，列线图和Web计算器程序的灵敏度较低，分别为0.500、0.609，即存在较高的假阴性率。相比内部验证，外部验证的AUC和灵敏度较低，这可能与模型应用于新数据集，存在不同的样本特征有关。内部验证通常是使用自身建模数据，故其各项预测评价指标常高于外部验证，其预测性能也常被高估[21]。因此，提示PSF风险预测模型需要不断进化、动态更新。
3.3　两种PSF风险预测模型的临床效用良好，建议选用Web计算器程序
Han等[22]认为优秀的预测模型应该使用简便、预测准确性高，同时具有可以接受的临床效益。然而，目前大多学者仅关注模型的预测准确性，常忽视模型的临床适用性和模型在临床运用后患者的获益状况。列线图包含年龄、糖尿病、抑郁状态、卒中后疼痛等四个预测因子，涉及单个量表，相比之下医护人员的评估工作量较小，但其AUC和灵敏度较低，具有简便性的同时牺牲了部分预测准确性。Web计算器程序包括性别、急性期疲劳、吞咽困难、抑郁状态、卒中前骨骼肌减少症等五个预测因子，涉及多个自评、他评量表，一定程度上会增加医护人员的评估工作量。但Web计算器程序的AUC、灵敏度、特异度及准确度略高于列线图，具有较好的预测效能。此外，Web计算器程序借助电脑网页计算预测概率，可降低因人工计算造成的误判率，减少因借助直尺反复比对计算而产生的评估时间，更具简便性和临床适用性。为平衡治疗护理和患者临床获益，本研究引入DCA来评估PSF风险预测模型在临床的适用性和效益，进而协助医护人员在临床中做出科学的临床决策[23]。DCA显示，在阈概率0.35～0.81和0.33～0.88范围内，分别利用列线图和Web计算器程序预测卒中恢复期患者的PSF风险并决定是否采取相应干预措施具有应用价值，可辅助提高医护人员的决策科学性并使卒中患者获益，其中Web计算器程序有更佳的临床适用性及效益。因此，建议医护人员依据临床需要选用Web计算器程序，同时未来可进一步更新简化该模型，实现简便性、准确性和临床效用三者间的平衡。
本研究发现，两种PSF风险预测模型具有中等程度的区分度、较好的校准度及良好的临床效用，有利于早期识别PSF高危患者。本研究结果显示，Web计算器程序的AUC（0.743）和DCA阈概率（0.33～0.88）均大于列线图，故建议选用预测效能更佳、临床效用更好的Web计算器程序。但本研究样本较小，可能存在部分偏倚。未来，可扩大样本进行多中心验证性研究；或进行前瞻性队列研究设计，利用更为客观的、易获取的、检测成本低廉的实验室指标构建并验证PSF风险预测模型，开发交互式Web计算器程序以便利临床推广应用，为医护人员临床决策和早期干预提供参考，降低PSF发生率。
基金
收起
  • 广西壮族自治区中医药管理局自筹经费科研课题(GXZYA 20220065)
  • 广西中医药大学高层次人才培育创新团队建设项目(2022A010)
  • 广西中医药大学引进博士科研启动基金项目(2023BS055)
文献
收起
参考文献 引证文献
排序方式：
[1]
王梅杰，邓雨芳，周翔，等.加拿大《最佳实践建议:卒中后抑郁、认知、疲劳》解读[J].中国全科医学，2021，24（17）：2214-2217.
Wang MJ, Deng YF, Zhou X, et al. Interpretation of the Canadian stroke best practice recommendations: mood, cognition and fatigue following stroke[J]. Chinese General Practice, 2021, 24(17): 2214-2217.
[2]
崔佩，孙玉姣，赵鑫，等.卒中后疲劳[J].国际脑血管病杂志，2022，30（7）：544-550.
Cui P, Sun YJ, Zhao X, et al. Post-stroke fatigue[J]. International Journal of Cerebrovascular Diseases, 2022, 30(7): 544-550.
[3]
Alghamdi I, Ariti C, Williams A, et al. Prevalence of fatigue after stroke: A systematic review and meta-analysis[J]. Eur Stroke J, 2021,6(4): 319-332.
[4]
English C, Simpson DB, Billinger SA, et al. A roadmap for research in post-stroke fatigue: Consensus-based core recommendations from the third Stroke Recovery and Rehabilitation Roundtable[J].Neurorehabilitation and Neural Repair, 2024, 38(1): 7-18.
[5]
Paudel SK, Rolls K, Green H, et al. Prevalence and impact of poststroke fatigue on patient outcomes in the first 6 months after stroke: a systematic review and meta-analysis[J]. The Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses, 2023, 55(5): 178-185.
[6]
Aali G, Drummond A, das Nair R, et al.Post-stroke fatigue: a scoping review[J]. F1000Research, 2020, 9: 242.
[7]
Collins GS, Reitsma JB, Altman DG, et al. Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis(TRIPOD): the TRIPOD Statement[J]. BMC Medicine, 2015, 162(1):55-63.
[8]
高雅云， 林丽.脑卒中后疲劳列线图预测模型的构建及评估[J].中外医学研究，2023，21（4）：139-143.
Gao YY, Lin L. Construction and verification of the nomogram prediction model of post-stroke fatigue[J]. Chinese and Foreign Medical Research,2023, 21(4): 139-143.
[9]
Su Y, Yuki M, Hirayama K, et al. Development and internal validation of a nomogram to predict Post-Stroke fatigue after discharge[J]. Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association, 2021, 30(2): 105484.
[10]
Ramspek CL, Jager KJ, Dekker FW, et al. External validation of prognostic models: what, why, how, when and where?[J]. Clinical Kidney Journal, 2021, 14(1): 49-58.
[11]
中华医学会神经病学分会， 中华医学会神经病学分会脑血管病学组.中国各类主要脑血管病诊断要点2019[J].中华神经科杂志，2019，52（9）：710-715.
Chinese Society of Neurology, Chinese Stroke Society. diagnostic criteria of cerebrovascular diseases in China(version 2019)[J]. Chin J Neurol, 2019, 52(9): 710-715.
[12]
Hinkle JL, Becker KJ, Kim JS, et al. Poststroke fatigue: emerging evidence and approaches to management: a scientific statement for healthcare professionals from the American heart association[J].Stroke, 2017, 48(7): e159-e170.
[13]
臧爽，崔赢，倪翠萍，等.卒中后疲劳评估工具的范围综述[J].中华护理杂志，2023，58（1）：46-54.
Zang S, Cui Y, Ni CP, et al. A scoping review of assessment tools for post-stroke fatigue[J]. Chinese Journal of Nursing, 2023, 58(1): 46-54.
[14]
陈擘璨， 吴孝文， 陈友红.急性缺血性脑卒中患者血清可溶性细胞黏附分子水平变化及其与卒中后疲劳的关系[J].中国医药，2022，17（10）：1491-1495.
Chen BC, Wu XW, Chen YH. Changes of serum soluble cellular adhesion molecule levels in patients with acute ischemic stroke and their relationship with post-stroke fatigue[J]. China Medicine, 2022, 17(10):1491-1495.
[15]
吴巧娣， 周静， 王硕.康复自我效能在老年脑卒中康复期患者卒中后抑郁与卒中后疲劳间的中介效应[J].护理学报，2021，28（17）：64-69.
Wu QD, Zhou J, Wang S. Mediation effect of rehabilitation self-efficacy between post-stroke depression and post-stroke fatigue in elderly patients recovering from stroke[J]. Journal of Nursing, 2021, 28(17): 64-69.
[16]
薛超，李娟，方茜，等.中国卒中后疲劳患病率及发展趋势的Meta分析[J].中国全科医学，2024，27（3）：364-374.
Xue C, Li J, Fang Q, et al. Prevalence and trends for post-stroke fatigue in China:a meta-analysis[J]. Chinese General Practice, 2024, 27(3): 364-374.
[17]
Coletti C, Acosta GF, Keslacy S, et al. Exercise-mediated reinnervation of skeletal muscle in elderly People: An update[J].European Journal of Translational Myology, 2022, 32(1): 10416.
[18]
任思强，张茜，代玉玺，等.脑卒中后疲劳发病机制及影响因素的研究进展[J].临床神经病学杂志，2021，34（3）：223-226.
Ren SQ, Zhang Q, Dai YX, et al. Research progress on the pathogenesis and influencing factors of physical fatigue after stroke[J]. Journal of Clinical Neurology, 2021, 34(3): 223-226.
[19]
Binuya MAE, Engelhardt EG, Schats W, et al. Methodological guidance for the evaluation and updating of clinical prediction models: a systematic review[J]. BMC Medical Research Methodology,2022, 22(1): 316.
[20]
Alba AC, Agoritsas T, Walsh M, et al. Discrimination and calibration of clinical prediction models: users' guides to the medical literature[J]. JAMA : the Journal of the American Medical Association, 2017, 318(14): 1377-1384.
[21]
Ho SY, Phua K, Wong L, et al. Extensions of the external validation for checking learned model interpretability and generalizability[J].Patterns (N Y), 2020, 1(8): 100129.
[22]
Han QY, Hu ZD. Clinical prediction model construction and evaluation: a challenge for clinical researchers[J]. Ann Transl Med,2020, 8(4): 74.
[23]
Vickers AJ, Holland F. Decision curve analysis to evaluate the clinical benefit of prediction models[J]. The Spine Journal, 2021, 21(10): 1643-1648.
2024年第51卷第7期
PDF下载
45
18
引用本文
BibTeX
文章信息
doi: 10.20043/j.cnki.MPM.202307262
  • 接收时间：2023-07-15
  • 首发时间：2026-03-18
  • 出版时间：2024-04-10
补充材料
相关文章
文章信息
作者
出版历史
  • 收稿日期：2023-07-15
基金
广西壮族自治区中医药管理局自筹经费科研课题(GXZYA 20220065)
广西中医药大学高层次人才培育创新团队建设项目(2022A010)
广西中医药大学引进博士科研启动基金项目(2023BS055)
作者信息
    广西中医药大学，广西 南宁 530200

通讯作者:

马秋平，E-mail:
参考文献
分享链接
https://castjournals.cast.org.cn/joweb/xdyfyx/CN/10.20043/j.cnki.MPM.202307262
分享至
全文二维码

扫描看全文

引用本文
BibTeX
本文的引用情况
2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
关闭全屏
相关链接
论文
最新文章
热读文章
热点专题
内参
蓝皮书
产业发展报告
传播力报告
期刊分级目录
资讯
学术新闻
行业新闻
学术会议
行业会议
关于
关于我们
联系我们
北京市海淀区学院南路86号
100081
010-62199257
qkjq@cast.org.cn

中国科学技术协会版权所有 京ICP 备10216604号-4 海淀分局备案 1101084647
科技导报社主办 中国科协信息中心技术支持