医学
原发性醛固酮增多症
验证性因素分析
内科学
曲线下面积
指南
接收机工作特性
临床实习
考试(生物学)
物理疗法
病理
结构方程建模
统计
醛固酮
数学
古生物学
生物
作者
Hiroki Kaneko,Hironobu Umakoshi,Tazuru Fukumoto,Norio Wada,Takamasa Ichijo,Shohei Sakamoto,Tetsuhiro Watanabe,Yuki Ishihara,Tetsuya Tagami,Masatoshi Ogata,Norifusa Iwahashi,Maki Yokomoto‐Umakoshi,Yayoi Matsuda,Ryuichi Sakamoto,Yoshihiro Ogawa
摘要
The clinical practice guideline for primary aldosteronism (PA) places a high value on confirmatory tests to sparing patients with false-positive results in case detection from undergoing adrenal venous sampling (AVS). However, it is unclear whether multiple types of confirmatory tests are more useful than a single type. To evaluate whether the machine-learned combination of two confirmatory tests is more useful in predicting subtypes of PA than each test alone.A retrospective cross-sectional study in referral centres.This study included 615 patients with PA randomly assigned to the training and test data sets. The participants underwent saline infusion test (SIT) and captopril challenge test (CCT) and were subtyped by AVS (unilateral, n = 99; bilateral, n = 516).The area under the curve (AUC) and clinical usefulness using decision curve analysis for the subtype prediction in the test data set.The AUCs for the combination of SIT and CCT, SIT alone and CCT alone were 0.850, 0.813 and 0.786, respectively, with no significant differences between them. The AUC for the baseline clinical characteristics alone was 0.872, whereas the AUCs for these combined with SIT, combined with CCT and combined with both SIT and CCT were 0.868, 0.854 and 0.855, respectively, with no significant improvement in AUC. The additional clinical usefulness of the second confirmatory test was unremarkable on decision curve analysis.Our data suggest that patients with positive case detection undergo one confirmatory test to determine the indication for AVS.
科研通智能强力驱动
Strongly Powered by AbleSci AI