Multicenter external validation of prediction models for clinical outcomes after spinal fusion for lumbar degenerative disease

作者：Alexandra Grob, Jonas Rohr, Vittorio Stumpo, Moira Vieli, Olga Ciobanu-Caraus, Luca Ricciardi, Nicolai Maldaner, Antonino Raco, Massimo Miscusi, Andrea Perna, Luca Proietti, Giorgio Lofrese, Michele Dughiero, Francesco Cultrera, Marcello D’Andrea, Seong Bae An, Yoon Ha, Aymeric Amelot, Jorge Bedia Cadelo, José Manuel Viñuela-Prieto, Maria L. Gandía-González, Pierre-Pascal Girod, Sara Lener, Nikolaus Kögl, Anto Abramović, Christoph J. Laux, Mazda Farshad, Dave O’Riordan, Markus Loibl, Fabio Galbusera, Anne F. Mannion, Alba Scerrati, Pasquale De Bonis, Granit Molliqaj, Enrico Tessitore, Marc L. Schröder, Martin N. Stienen, Luca Regli, Carlo Serra, Victor E. Staartjes · 发表于：European Spine Journal · 年份：2024 · DOI：10.1007/s00586-024-08395-3 · 被引用次数：5 · 研究领域：Spine and Intervertebral Disc Pathology、Medical Imaging and Analysis、Scoliosis diagnosis and treatment

BACKGROUND: Clinical prediction models (CPM), such as the SCOAP-CERTAIN tool, can be utilized to enhance decision-making for lumbar spinal fusion surgery by providing quantitative estimates of outcomes, aiding surgeons in assessing potential benefits and risks for each individual patient. External validation is crucial in CPM to assess generalizability beyond the initial dataset. This ensures performance in diverse populations, reliability and real-world applicability of the results. Therefore, we externally validated the tool for predictability of improvement in oswestry disability index (ODI), back and leg pain (BP, LP). METHODS: Prospective and retrospective data from multicenter registry was obtained. As outcome measure minimum clinically important change was chosen for ODI with ≥ 15-point and ≥ 2-point reduction for numeric rating scales (NRS) for BP and LP 12 months after lumbar fusion for degenerative disease. We externally validate this tool by calculating discrimination and calibration metrics such as intercept, slope, Brier Score, expected/observed ratio, Hosmer-Lemeshow (HL), AUC, sensitivity and specificity. RESULTS: We included 1115 patients, average age 60.8 ± 12.5 years. For 12-month ODI, area-under-the-curve (AUC) was 0.70, the calibration intercept and slope were 1.01 and 0.84, respectively. For NRS BP, AUC was 0.72, with calibration intercept of 0.97 and slope of 0.87. For NRS LP, AUC was 0.70, with calibration intercept of 0.04 and slope of 0.72. Sensitivit...