Cargando…
Development and internal validation of a predictive model of cognitive decline 36 months following elective surgery
INTRODUCTION: Our goal was to determine if features of surgical patients, easily obtained from the medical chart or brief interview, could be used to predict those likely to experience more rapid cognitive decline following surgery. METHODS: We analyzed data from an observational study of 560 older...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8140204/ https://www.ncbi.nlm.nih.gov/pubmed/34046520 http://dx.doi.org/10.1002/dad2.12201 |
_version_ | 1783696143067119616 |
---|---|
author | Jones, Richard N. Tommet, Douglas Steingrimsson, Jon Racine, Annie M. Fong, Tamara G. Gou, Yun Hshieh, Tammy T. Metzger, Eran D. Schmitt, Eva M. Tabloski, Patricia A. Travison, Thomas G. Vasunilashorn, Sarinnapha M. Abdeen, Ayesha Earp, Brandon Kunze, Lisa Lange, Jeffrey Vlassakov, Kamen Dickerson, Bradford C. Marcantonio, Edward R. Inouye, Sharon K. |
author_facet | Jones, Richard N. Tommet, Douglas Steingrimsson, Jon Racine, Annie M. Fong, Tamara G. Gou, Yun Hshieh, Tammy T. Metzger, Eran D. Schmitt, Eva M. Tabloski, Patricia A. Travison, Thomas G. Vasunilashorn, Sarinnapha M. Abdeen, Ayesha Earp, Brandon Kunze, Lisa Lange, Jeffrey Vlassakov, Kamen Dickerson, Bradford C. Marcantonio, Edward R. Inouye, Sharon K. |
author_sort | Jones, Richard N. |
collection | PubMed |
description | INTRODUCTION: Our goal was to determine if features of surgical patients, easily obtained from the medical chart or brief interview, could be used to predict those likely to experience more rapid cognitive decline following surgery. METHODS: We analyzed data from an observational study of 560 older adults (≥70 years) without dementia undergoing major elective non‐cardiac surgery. Cognitive decline was measured using change in a global composite over 2 to 36 months following surgery. Predictive features were identified as variables readily obtained from chart review or a brief patient assessment. We developed predictive models for cognitive decline (slope) and predicting dichotomized cognitive decline at a clinically determined cut. RESULTS: In a hold‐out testing set, the regularized regression predictive model achieved a root mean squared error (RMSE) of 0.146 and a model r‐square (R(2)) of .31. Prediction of “rapid” decliners as a group achieved an area under the curve (AUC) of .75. CONCLUSION: Some of our models could predict persons with increased risk for accelerated cognitive decline with greater accuracy than relying upon chance, and this result might be useful for stratification of surgical patients for inclusion in future clinical trials. |
format | Online Article Text |
id | pubmed-8140204 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-81402042021-05-26 Development and internal validation of a predictive model of cognitive decline 36 months following elective surgery Jones, Richard N. Tommet, Douglas Steingrimsson, Jon Racine, Annie M. Fong, Tamara G. Gou, Yun Hshieh, Tammy T. Metzger, Eran D. Schmitt, Eva M. Tabloski, Patricia A. Travison, Thomas G. Vasunilashorn, Sarinnapha M. Abdeen, Ayesha Earp, Brandon Kunze, Lisa Lange, Jeffrey Vlassakov, Kamen Dickerson, Bradford C. Marcantonio, Edward R. Inouye, Sharon K. Alzheimers Dement (Amst) Diagnostic Assessment & Prognosis INTRODUCTION: Our goal was to determine if features of surgical patients, easily obtained from the medical chart or brief interview, could be used to predict those likely to experience more rapid cognitive decline following surgery. METHODS: We analyzed data from an observational study of 560 older adults (≥70 years) without dementia undergoing major elective non‐cardiac surgery. Cognitive decline was measured using change in a global composite over 2 to 36 months following surgery. Predictive features were identified as variables readily obtained from chart review or a brief patient assessment. We developed predictive models for cognitive decline (slope) and predicting dichotomized cognitive decline at a clinically determined cut. RESULTS: In a hold‐out testing set, the regularized regression predictive model achieved a root mean squared error (RMSE) of 0.146 and a model r‐square (R(2)) of .31. Prediction of “rapid” decliners as a group achieved an area under the curve (AUC) of .75. CONCLUSION: Some of our models could predict persons with increased risk for accelerated cognitive decline with greater accuracy than relying upon chance, and this result might be useful for stratification of surgical patients for inclusion in future clinical trials. John Wiley and Sons Inc. 2021-05-21 /pmc/articles/PMC8140204/ /pubmed/34046520 http://dx.doi.org/10.1002/dad2.12201 Text en © 2021 The Authors. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals, LLC on behalf of Alzheimer's Association https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Diagnostic Assessment & Prognosis Jones, Richard N. Tommet, Douglas Steingrimsson, Jon Racine, Annie M. Fong, Tamara G. Gou, Yun Hshieh, Tammy T. Metzger, Eran D. Schmitt, Eva M. Tabloski, Patricia A. Travison, Thomas G. Vasunilashorn, Sarinnapha M. Abdeen, Ayesha Earp, Brandon Kunze, Lisa Lange, Jeffrey Vlassakov, Kamen Dickerson, Bradford C. Marcantonio, Edward R. Inouye, Sharon K. Development and internal validation of a predictive model of cognitive decline 36 months following elective surgery |
title | Development and internal validation of a predictive model of cognitive decline 36 months following elective surgery |
title_full | Development and internal validation of a predictive model of cognitive decline 36 months following elective surgery |
title_fullStr | Development and internal validation of a predictive model of cognitive decline 36 months following elective surgery |
title_full_unstemmed | Development and internal validation of a predictive model of cognitive decline 36 months following elective surgery |
title_short | Development and internal validation of a predictive model of cognitive decline 36 months following elective surgery |
title_sort | development and internal validation of a predictive model of cognitive decline 36 months following elective surgery |
topic | Diagnostic Assessment & Prognosis |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8140204/ https://www.ncbi.nlm.nih.gov/pubmed/34046520 http://dx.doi.org/10.1002/dad2.12201 |
work_keys_str_mv | AT jonesrichardn developmentandinternalvalidationofapredictivemodelofcognitivedecline36monthsfollowingelectivesurgery AT tommetdouglas developmentandinternalvalidationofapredictivemodelofcognitivedecline36monthsfollowingelectivesurgery AT steingrimssonjon developmentandinternalvalidationofapredictivemodelofcognitivedecline36monthsfollowingelectivesurgery AT racineanniem developmentandinternalvalidationofapredictivemodelofcognitivedecline36monthsfollowingelectivesurgery AT fongtamarag developmentandinternalvalidationofapredictivemodelofcognitivedecline36monthsfollowingelectivesurgery AT gouyun developmentandinternalvalidationofapredictivemodelofcognitivedecline36monthsfollowingelectivesurgery AT hshiehtammyt developmentandinternalvalidationofapredictivemodelofcognitivedecline36monthsfollowingelectivesurgery AT metzgererand developmentandinternalvalidationofapredictivemodelofcognitivedecline36monthsfollowingelectivesurgery AT schmittevam developmentandinternalvalidationofapredictivemodelofcognitivedecline36monthsfollowingelectivesurgery AT tabloskipatriciaa developmentandinternalvalidationofapredictivemodelofcognitivedecline36monthsfollowingelectivesurgery AT travisonthomasg developmentandinternalvalidationofapredictivemodelofcognitivedecline36monthsfollowingelectivesurgery AT vasunilashornsarinnapham developmentandinternalvalidationofapredictivemodelofcognitivedecline36monthsfollowingelectivesurgery AT abdeenayesha developmentandinternalvalidationofapredictivemodelofcognitivedecline36monthsfollowingelectivesurgery AT earpbrandon developmentandinternalvalidationofapredictivemodelofcognitivedecline36monthsfollowingelectivesurgery AT kunzelisa developmentandinternalvalidationofapredictivemodelofcognitivedecline36monthsfollowingelectivesurgery AT langejeffrey developmentandinternalvalidationofapredictivemodelofcognitivedecline36monthsfollowingelectivesurgery AT vlassakovkamen developmentandinternalvalidationofapredictivemodelofcognitivedecline36monthsfollowingelectivesurgery AT dickersonbradfordc developmentandinternalvalidationofapredictivemodelofcognitivedecline36monthsfollowingelectivesurgery AT marcantonioedwardr developmentandinternalvalidationofapredictivemodelofcognitivedecline36monthsfollowingelectivesurgery AT inouyesharonk developmentandinternalvalidationofapredictivemodelofcognitivedecline36monthsfollowingelectivesurgery |