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- Title
A prediction model and nomogram for technical difficulty of peroral endoscopic myotomy.
- Authors
Liu, Xin-Yang; Geng, Zi-Han; Chen, Wei-Feng; Xu, Mei-Dong; Chen, Shi-Yao; Zhong, Yun-Shi; Zhang, Yi-Qun; Ma, Li-Li; Qin, Wen-Zheng; Hu, Jian-Wei; Cai, Ming-Yan; Li, Quan-Lin; Zhou, Ping-Hong
- Abstract
Background and aims: Peroral endoscopic myotomy (POEM) is a promising endoscopic technique for achalasia. We aimed to establish a regression model and develop a simple nomogram to predict the technical difficulty of POEM in a single center with large volume cases. Methods: 3385 achalasia patients treated with POEM were included, and the technical difficulty was systemically evaluated. All of them were randomized into the training cohort (n = 1693) or internal validation cohort (n = 1692). Then, the prediction model and nomogram were proposed based on multivariate logistic regression analysis in the training cohort and assessed in the validation cohort. Results: Of 3385 patients, technical difficulty happened in 417 (12.32%) cases. In the training stage, six factors were weighted based on the β coefficient from the regression model, including age, disease duration, sigmoid esophagus, mucosal edema, submucosal fibrosis, and tunnel length. The patients were categorized into low-risk (< 0.1), medium-risk (0.1–0.25), and high-risk (> = 0.25) groups. Our score model performed satisfying discrimination with the areas under the receiver-operating characteristic curve (AUC) of 0.743 (95% confidence interval (CI), 0.701–0.785) and calibration with goodness of fit in the Hosmer–Lemeshow test (P = 0.088) in internal validation. Conclusions: The prediction model and nomogram demonstrated good performance in predicting the technical difficulty of POEM.
- Subjects
NOMOGRAPHY (Mathematics); PREDICTION models; LOGISTIC regression analysis; MYOTOMY; GOODNESS-of-fit tests; REGRESSION analysis; ESOPHAGEAL achalasia
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2023, Vol 37, Issue 4, p2781
- ISSN
1866-6817
- Publication type
Article
- DOI
10.1007/s00464-022-09798-3