Scientific research
Construction of risk warning index system for multidrug resistance organisms infection control and management in hospitalized patients
HOU Yuan,CHEN Xiaoxia,WANG Bingzhang,LU Hongmei,ZHAO Yajing Show Abstract Online reading
Objective: To construct risk warning index system for multidrug resistance organisms infection control and management in hospitalized patients. Methods: Based on previous research,guided by risk cognition theory and risk warning theory,with three⁃dimensional model of structure,process,result as the framework,risk warning index system for multidrug resistance organisms infection control and management in hospitalized patients(draft) was developed by literature review and semi⁃structured interview methods.Then,risk warning index system for multidrug resistance organisms infection control and management in hospitalized patients was further improved by Delphi expert inquiry method. Results: The effective response rates of the 2 rounds of expert inquiry questionnaires were both 100%,expert authority coefficients was 0.950,coefficient of variation of expert inquiry were from 0.025 to 0.227 and from 0.028 to 0.224,and Kendall harmony coefficients were 0.434 and 0.473(both <0.001).The final constructed risk warning index system for multidrug resistance organisms infection control and management in hospitalized patients included 3 first⁃level indicators,8 second⁃level indicators,and 64 third⁃level indicators. Conclusions: The risk warning index system for multidrug resistance organisms infection control and management in hospitalized patients constructed in this study is scientific,reliable,purposeful and quantifiable.
Construction of risk prediction model of sarcopenia in senile patients with stroke based on Logistic regression and decision tree
KONG Linghui,YU Jie,ZHANG Huijun,CHEN Ping Show Abstract Online reading
Objective: To explore the factors affecting sarcopenia in senile patients with stroke,construct risk prediction models,and evaluate their accuracy of prediction. Methods: A total of 489 senile patients with stroke from neurology department of a tertiary grade A hospital in Liaoning province were selected as the research subjects from September 2022 to April 2023.The risk prediction models of sarcopenia were constructed according to the results of Logistic regression analysis.The Nomogram and decision tree were painted,and the prediction efficiency of models were evaluated according to area under the curve(AUC) of receiver operator characteristic and confusion matrix. Results: The incidence of sarcopenia in senile patients with stroke was 37.6%.The results of logistic regression analysis show that smoking,age,activity of daily living(ADL),fall risk,nutrition and exercise habits were effect factors for sarcopenia in senile patients with stroke(<0.05).The results of decision tree model showed that smoking,age,ADL, nutrition and exercise habits were decision-making factors for the sarcopenia in senile patients with stroke. The AUC of Logistic regression model was 0.959,and that of decision tree model training set and test set were 0.892 and 0.826,respectively. Conclusions: The Logistic regression model and decision tree model construct in this study have good predictive performance,which is helpful for clinical medical staff to screen the high-risk group of sarcopenia.
Construction and validation of a risk prediction model for deep vein thrombosis in orthopedic patients during surgery
LYU Mengshuang,ZHENG Xican,XIE Suli,SUN Zhiyan,QU Jingrui,LIU Ruiting Show Abstract Online reading
Objective: To construct a risk prediction model for deep vein thrombosis(DVT) in orthopedic patients during surgery and verify it. Methods: Patients admitted to our hospital who require orthopedic surgery treatment were selected as the research subjects from January 2021 to December 2022.272 patients undergoing orthopedic surgery from January 2021 to April 2022 were selected as the modeling group,and 151 patients undergoing orthopedic surgery from May to December 2022 were selected as the external validation group.Patient general information,medical history,laboratory test indicators,and operating room indicators were investigated.The influencing factors of DVT in orthopedic patients during surgery were analyzed.A predictive model was constructed.And Nomogram was drawn. Results: Among 423 patients,97 patients with DVT,the incidence of DVT was 23%.The results of multivariate analysis showed that age,body mass index(BMI),D-dimer,surgical duration,whether blood transfusion was performed during surgery or not,intraoperative bleeding volume,and whether bone cement was used or not were the influencing factors of DVT in orthopedic patients during surgery.The goodness of fit test results of the risk prediction model constructed based on these influencing factors showed that,=1.643,=0.897.Area under the curve(AUC) of receiver operator characteristic of the modeling group was 0.872,the maximum value of the Youden index was 0.750,the optimal critical value was 0.079,the sensitivity was 75%,and the specificity was 86%.The AUC of receiver operator characteristic of the external validation group was 0.837,the maximum value of Youden index was 0.728,the sensitivity was 72%, the specificity was 82%,and the diagnostic value was 0.165. Conclusions: Age,body mass index(BMI),D⁃dimer,surgical duration,whether blood transfusion was performed during surgery or not,intraoperative bleeding volume,and whether bone cement was used or not have effect on DVT in orthopedic patients.The model constructed based on these influencing factors can better predict the risk of DVT in orthopedic patients during surgery.
Development of social capital scale for poverty⁃alleviation relocated elderly and its reliability and validity test
GUO Yuting,YANG Le,LI Zeyuan,CHENG Jingmin Show Abstract Online reading
Objective: To develop a social capital scale for poverty⁃alleviation relocated elderly and test its reliability and validity. Methods: Based on the social capital evaluation item system constructed by our research group in the early stage,a social capital scale for poverty⁃alleviation relocated elderly was constructed through expert inquiries. A total of 1 874 elderly from 24 poverty⁃alleviation relocation resettlement areas in Shanxi province were selected for household surveys. Results: The social capital scale for poverty⁃alleviation relocated elderly was developed,which included 6 dimensions and 33 items.Exploratory factor analysis extracted 6 common factors with feature roots>1, with cumulative contribution rate of 61.892%.The results of confirmatory factor analysis showed that the performance factor loadings of each item on the corresponding factors were ranged from 0.389 to 0.965 after adjustment,and the chi⁃square degree of freedom ratio was 2.962,comparative goodness of fit index was 0.923,Tucker⁃Lewis index was 0.912,root mean square residual was 0.046,standardized root mean square residual was 0.044,item⁃level content validity index were ranged from 0.800 to 1.000,average scale⁃level content validity index was 0.953.The total Cronbach's α coefficient was 0.926,and the split half reliability coefficient was 0.660. Conclusions: The social capital scale for poverty⁃alleviation relocated elderly has high reliability and validity,and can be used as a measurement tool for the social capital of poverty⁃alleviation relocated elderly.
Risk prediction models for post⁃stroke cognitive impairment: a systematic review
ZHANG Jie,XI Chongcheng,KONG Yun,ZHONG Kelong,AN Xuemei Show Abstract Online reading
Objective: To systematically evaluate the risk prediction models for post⁃stroke cognitive impairment. Methods: Research related to risk prediction models for post⁃stroke cognitive impairment was retrieved from China National Knowledge Infrastructure,Wanfang Data,China Biology Medicine database,PubMed,EMbase,the Cochrane Library,Web of Science,and EBSCO.The retrieval period was from establishment of databases to January 30,2023. 2 researchers independently screened the literature,extracted data,and evaluated the risk of bias and applicability for inclusion in the study. Results: A total of 16 studies were included,including 19 risk prediction models for post⁃stroke cognitive impairment.Among them,16 models used Logistic regression analysis,2 models used random forest method,and 1 model used LASSO regression method.The area under the curve(AUC) of receiver operator characteristic during modeling were ranged from 0.773 to 0.940.4 models were subjected to the Hosmer⁃Lemeshow(H⁃L) test,with 2 models reported ⁃values and their ≥0.05.11 models underwent internal validation,5 models underwent external validation, and 4 models underwent both internal and external validation simultaneously.The 16 studies had good applicability, but there was a high bias,and the main problem was concentrated in the analysis field. Conclusions: The overall performance of the risk prediction models for post⁃stroke cognitive impairment is good,but the quality of the models need to be improved.In future research,it is necessary to optimize the research: design,expand the sample size,select appropriate predictive factors according to clinical needs,improve statistical analysis methods.It also should focus on external validation of the model to verify its generalization ability.
Effects of seven rehabilitation exercises on balance and walking function in stroke patients: a network Meta⁃analysis
BAI Yunfei,GU Zejuan,YANG Lei,WANG Xuemei,MA Beibei Show Abstract Online reading
Objective: To evaluate the effects of seven rehabilitation exercises on balance and walking function in stroke patients. Methods: Randomized controlled trials about the effects of rehabilitation exercises on balance and walking function in stroke patients were retrieved in databases including PubMed,Web of Science,EMbase,the Cochrane Library,CNKI,Wanfang,VIP and SinoMed from inception to March 28,2023.Two researchers independently perform literature screening,content extraction and quality evaluation.Stata 17.0 was used to conduct a network meta⁃analysis. Results: A total of 16 articles were included,with 1 006 patients, involving 7 rehabilitation exercises.The results of the network meta-analysis showed that core stability training,resistance training,motor imagination therapy,mirror therapy,aquatic therapeutic exercise,and virtual reality could improve balance function compared with conventional rehabilitation exercise in stroke patients(<0.05).Core stability training,resistance training,motor imagination therapy,mirror therapy,and virtual reality could improve walking function in stroke patients(<0.05).Core stability training ranked first in SUCRA. Conclusions: A variety of rehabilitation exercises can improve balance and walking function in stroke patients,and core stability training has the best effect.