Development and Assessment of Prediction Models for the Development of COPD in a Typical Rural Area in Northwest China

• Published in: International journal of chronic obstructive pulmonary disease 2021, Vol.16, p.477-486
• Main Authors: Wang, Yide, Li, Zheng, Li, Feng-Sen
• Format: Article
• Language: English
• Subjects: Accuracy; Age; Analysis; Biodiesel fuels; Biofuels; Calibration; china; China - epidemiology; Chronic illnesses; Chronic obstructive pulmonary disease; Coal; copd; Cross-Sectional Studies; Disease prevention; Humans; Lung diseases; Lung diseases, Obstructive; Medical research; Medicine, Experimental; Models, Statistical; Mortality; nomograms; Original Research; Population; predictive models; Prognosis; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - epidemiology; Regression analysis; Retrospective Studies; Risk Factors; Rural areas; Smoking; Ventilation
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S297380

This study aimed to construct and evaluate a clinical predictive model for the development of COPD in northwest China's rural areas. A cross-sectional study of a natural population was performed in rural northwest China. After assessing demographic and disease characteristics, a clinical prediction model was developed. First, we used the least absolute shrinkage and selection operator regression model to screen possible factors influencing COPD. Then construct a logistic regression model and draw a nomogram. The discriminability of the model was further evaluated by the calibration diagram, C-index and ROC curve system. Clinical benefit was analyzed using the decision curve. Finally, the 1000 bootstrap resamples and Harrell's C-index was used for internal verification of the nomogram. Among 3249 patients in the local rural natural population, 394 (12.13%) were diagnosed with COPD. The LASSO regression model was used to find the optimal combination of parameters, and the screened influencing factors included age, gender, barbeque, smoking, passive smoking, energy type, ventilation system and Post-Bronchodilator FEV1. These predictors are used to construct a nomogram. C index is 0.81 (95% confidence interval:0.79-0.83). The combination of the calibration curve and ROC curve indicates that the model has high discriminability. The decision curve shows benefits in clinical practice when the threshold probability is >6% and