1. Integrating clinical and biochemical markers: a novel nomogram for predicting lacunes in cerebral small vessel disease.
- Author
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Ning Li, Ya-Dong Hu, Ye Jiang, Li Ling, Chu-Han Wang, Jia-Min Shao, Si-Bo Li, and Wei-Ying Di
- Subjects
RISK assessment ,MEDICAL history taking ,HOMOCYSTEINE ,PREDICTION models ,RESEARCH funding ,RECEIVER operating characteristic curves ,ACADEMIC medical centers ,CREATININE ,LACUNAR stroke ,LOGISTIC regression analysis ,FISHER exact test ,BRAIN ,SEX distribution ,HYPERTENSION ,MAGNETIC resonance imaging ,DESCRIPTIVE statistics ,RETROSPECTIVE studies ,CHI-squared test ,BIOCHEMISTRY ,AGE distribution ,CAROTID artery stenosis ,LABORATORY test panels ,LONGITUDINAL method ,CEREBRAL small vessel diseases ,RESEARCH ,STROKE rehabilitation ,COMPARATIVE studies ,CONFIDENCE intervals ,CALIBRATION ,DATA analysis software ,EARLY diagnosis ,BIOMARKERS ,REGRESSION analysis ,SENSITIVITY & specificity (Statistics) ,DISEASE risk factors ,DISEASE complications - Abstract
Background: Lacunes, a characteristic feature of cerebral small vessel disease (CSVD), are critical public health concerns, especially in the aging population. Traditional neuroimaging techniques often fall short in early lacune detection, prompting the need for more precise predictive models. Methods: In this retrospective study, 587 patients from the Neurology Department of the Affiliated Hospital of Hebei University who underwent cranial MRI were assessed. A nomogram for predicting lacune incidence was developed using LASSO regression and binary logistic regression analysis for variable selection. The nomogram's performance was quantitatively assessed using AUC-ROC, calibration plots, and decision curve analysis (DCA) in both training (n = 412) and testing (n = 175) cohorts. Results: Independent predictors identified included age, gender, history of stroke, carotid atherosclerosis, hypertension, creatinine, and homocysteine levels. The nomogram showed an AUC-ROC of 0.814 (95% CI: 0.791-0.870) for the training set and 0.805 (95% CI: 0.782-0.843) for the testing set. Calibration and DCA corroborated the model's clinical value. Conclusion: This study introduces a clinically useful nomogram, derived from binary logistic regression, that significantly enhances the prediction of lacunes in patients undergoing brain MRI for various indications, potentially advancing early diagnosis and intervention. While promising, its retrospective design and single-center context are limitations that warrant further research, including multi-center validation. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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