Continuous and bimonthly publication
ISSN (on-line): 1806-3756

Licença Creative Commons
1223
Views
Back to summary
Open Access Peer-Reviewed
Artigo Original

External validation of the parsimonious EuroLung risk models: analysis of the Brazilian Lung Cancer Registry

Paula Duarte D’Ambrosio1, Ricardo Mingarini Terra1, Alessandro Brunelli2, Leticia Leone Lauricella1, Carolina Adan Cavadas1, Jaqueline Schaparini Fonini1, Jefferson Luiz Gross3, Federico Enrique Garcia Cipriano4, Fabio May da Silva5, Paulo Manuel Pêgo-Fernandes1

ABSTRACT

Objective: The purpose of this study was to assess performance in the Brazilian Lung Cancer Registry Database by using the parsimonious EuroLung risk models for morbidity and mortality. Methods: The EuroLung1 and EuroLung2 models were tested and evaluated through calibration (calibration plot, Brier score, and the Hosmer-Lemeshow test) and discrimination (ROC AUCs), in a national multicenter registry of 1,031 patients undergoing anatomic lung resection. Results: The evaluation of performance in Brazilian health care facilities utilizing risk-adjustment models, specifically EuroLung1 and EuroLung2, revealed substantial miscalibration, as evidenced by calibration plots and Hosmer-Lemeshow tests in both models. In terms of calibration, EuroLung1 exhibited a calibration plot with overlapping points, characterized by a slope of 1.11 and a Brier score of 0.15; the Hosmer-Lemeshow test yielded a statistically significant p-value of 0.015; and the corresponding ROC AUC was 0.678 (95% CI: 0.636-0.721). The EuroLung2 model displayed better calibration, featuring fewer overlapping points in the calibration plot, with a slope of 1.22, with acceptable discrimination, as indicated by a ROC AUC of 0.756 (95% CI: 0.670-0.842). Both models failed to accurately predict morbidity and mortality outcomes in this specific health care context. Conclusions: Discrepancies between the EuroLung model predictions and outcomes in Brazil underscore the need for model refinement and for a probe into inefficiencies in the Brazilian health care system. (Plataforma Brasil identifier: 16424413.2.1001.0065. [https://plataformabrasil.saude.gov.br/])

Keywords: Quality of health care; Models, statistical; Public health; Morbidity; Lung neoplasms.


THE CONTENT OF THIS ARTICLE IS NOT AVAILABLE FOR THIS LANGUAGE.


Indexes

Development by:

© All rights reserved 2024 - Jornal Brasileiro de Pneumologia