Development and external validation of a prognostic model for survival of people living with HIV/AIDS initiating antiretroviral therapy

Wang, Junfeng; Yuan, Tanwei; Ding, Haibo; Xu, Junjie; Keusters, Willem R.; Ling, Xuemei; Fu, Leiwen; Zhu, Qiyu; Li, Quanmin; Tang, Xiaoping; Cai, Weiping; Shang, Hong; Li, Linghua; Zou, Huachun

doi:10.1016/j.lanwpc.2021.100269

Cited by 8 publications

(8 citation statements)

References 48 publications

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“…We selected potential predictors of the first AIDS-defining event developed after more than one year of continuous ART on the basis of prior research and availability in our dataset [ 15 – 18 ]. These included age at ART initiation, gender, transmission mode, country of origin, CD4 count at ART initiation, plasma HIV-1 RNA viral load (VL) at ART initiation, and a diagnosis of a previous AIDS event before or at ART initiation.…”

Section: Methodsmentioning

confidence: 99%

AIDS-defining events among people living with HIV who have been under continuous antiretroviral therapy for more than one year, a German cohort study 1999–2018

Pantke,

Kollan,

Gunsenheimer-Bartmeyer

et al. 2024

Infection

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Purpose This study examined the characteristics, incidence and prognostic factors of the first AIDS-defining condition developed after more than one year of continuous antiretroviral therapy (ART) among people living with HIV (PLHIV). Methods We used data from two multicentre observational cohorts of PLHIV in Germany between 1999 and 2018. Our outcome was the first AIDS-defining event that occurred during follow-up after more than one year of continuous ART. Descriptive analyses at ART initiation, at the time of the AIDS event and of the most frequently observed types of AIDS-defining illnesses were performed. We calculated the incidence rate (IR) per 1000 person-years (PY) and used a bootstrap stepwise selection procedure to identify predictors of the outcome. Results A total of 12,466 PLHIV were included in the analyses. 378 developed the outcome, constituting an overall IR of 5.6 (95% CI 5.1–6.2) AIDS events per 1000 PY. The majority of PLHIV was virally suppressed at the time of the event. Oesophageal candidiasis and wasting syndrome were the most frequently diagnosed AIDS-defining illnesses. We found a low CD4 count at ART initiation, a previous AIDS-defining condition and transmission through intravenous drug use to be meaningful prognostic factors of the outcome. Conclusion The overall rate of AIDS-defining events among PLHIV under long-term ART was low, highlighting the importance of continuous treatment. PLHIV who started ART with indicators of impaired immune functioning were more susceptible to disease progression, suggesting that the public health response should continue to focus on early and sustained treatment for all PLHIV.

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Section: Methodsmentioning

confidence: 99%

AIDS-defining events among people living with HIV who have been under continuous antiretroviral therapy for more than one year, a German cohort study 1999–2018

Pantke,

Kollan,

Gunsenheimer-Bartmeyer

et al. 2024

Infection

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“…There are two fundamental aspects, discrimination and calibration, to evaluate the performance of the model. Discrimination refers to the ability of a model to differentiate between high-risk patients and low-risk patients ( 18 ). It is represented by Harrell’s c-index of concordance (C-index) ( 19 ).…”

Section: Methodsmentioning

confidence: 99%

“…Through the “cindex” function of the “pec” R package ( 21 ), the dynamic time-dependent C-index curve of each dataset was plotted. Calibration refers to the agreement between the predicted and observed survival probabilities ( 18 ). The calibration plot was applied to assess the calibration of our model at 1, 3 and 5 years respectively by the “rms” R package ( 17 ).…”

Section: Methodsmentioning

confidence: 99%

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Development and Validation of Prognostic Model for Lung Adenocarcinoma Patients Based on m6A Methylation Related Transcriptomics

Liu

Shen

et al. 2022

Front. Oncol.

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Existing studies suggest that m6A methylation is closely related to the prognosis of cancer. We developed three prognostic models based on m6A-related transcriptomics in lung adenocarcinoma patients and performed external validations. The TCGA-LUAD cohort served as the derivation cohort and six GEO data sets as external validation cohorts. The first model (mRNA model) was developed based on m6A-related mRNA. LASSO and stepwise regression were used to screen genes and the prognostic model was developed from multivariate Cox regression model. The second model (lncRNA model) was constructed based on m6A related lncRNAs. The four steps of random survival forest, LASSO, best subset selection and stepwise regression were used to screen genes and develop a Cox regression prognostic model. The third model combined the risk scores of the first two models with clinical variable. Variables were screened by stepwise regression. The mRNA model included 11 predictors. The internal validation C index was 0.736. The lncRNA model has 15 predictors. The internal validation C index was 0.707. The third model combined the risk scores of the first two models with tumor stage. The internal validation C index was 0.794. In validation sets, all C-indexes of models were about 0.6, and three models had good calibration accuracy. Freely online calculator on the web at https://lhj0520.shinyapps.io/LUAD_prediction_model/.

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“…27 One study modeled the progression or regression of hypertension as the outcome (Table 2: Models 14-15), and another modeled the transition between normotensive, pre-hypertensive, and hypertensive status (Table 2: Model 32). 28,29 All studies excluded participants with hypertension at baseline. Most studies defined hypertension as SBP ≥ 140mmHg or DBP ≥ 90 mmHg, or the use of antihypertensive medication or treatment.…”

Section: Model Development Studiesmentioning

confidence: 99%

Predicting the risk of incident hypertension and increase in blood pressure: A systematic review of existing prediction models for adults

Bajwa

Levine

Bautista

2023

Preprint

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Background and aims: Models that can predict the risk of developing essential hypertension or increase in blood pressure (BP) can be used to identify high risk individuals. We aimed to summarize and assess prediction models developed in the general adult population using longitudinal data, as well as any external validation of such models. Methods: For this systematic review, we searched the literature on Medline and Embase for studies published between database inception and February 5, 2021. We conducted a narrative synthesis of all models and assessed the risk of bias (ROB) in included studies using PROBAST. We also performed a meta-analysis of all external validation studies validating the Framingham hypertension risk model. We excluded models based on cross-sectional data, or those based on specific patient populations. Results: Our review includes 29 articles which contain 42 prediction models and 11 external validation studies of existing prediction models. Among model development studies, only five models performed both internal and external validation. Among the validation studies, only two existing models were externally validated by researchers other than the ones who developed the model. Most models had low ROB in the predictors and outcomes domains, and half had low ROB in the participants domain. However, all had high ROB in the analysis domain due to inappropriate handling of missing data and/or lack of adequate performance measures, which resulted in high overall ROB for all models. Conclusions: All current risk prediction models predicting hypertension or increased blood pressure have high ROB and most have not been externally validated. New studies should aim to reduce their ROB using standard reporting guidelines and externally validated existing models.

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Development and external validation of a prognostic model for survival of people living with HIV/AIDS initiating antiretroviral therapy

Cited by 8 publications

References 48 publications

AIDS-defining events among people living with HIV who have been under continuous antiretroviral therapy for more than one year, a German cohort study 1999–2018

AIDS-defining events among people living with HIV who have been under continuous antiretroviral therapy for more than one year, a German cohort study 1999–2018

Development and Validation of Prognostic Model for Lung Adenocarcinoma Patients Based on m6A Methylation Related Transcriptomics

Predicting the risk of incident hypertension and increase in blood pressure: A systematic review of existing prediction models for adults

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