Development and validation of a prediction model based on a nomogram for tuberculous pleural effusion

BackgroundDiagnosing tuberculous pleural effusion (TPE) is challenging. There is a lack of cross-sectional lateral comparisons among TPE prediction models.ObjectivesWe aimed to develop and validate a novel TPE prediction model and compare its diagnostic performance with that of existing models.Metho...

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Main Authors: Suli Liu, Yao Yang, Dongmei Wang, Lijuan Gao, Jiangyue Qin, Yanqiu Wu, Diandian Li, Xiaohua Li, Mei Chen, Hao Wang, Yongchun Shen, Fuqiang Wen, Fangying Chen
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1589406/full
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author Suli Liu
Suli Liu
Yao Yang
Yao Yang
Dongmei Wang
Lijuan Gao
Lijuan Gao
Jiangyue Qin
Jiangyue Qin
Yanqiu Wu
Yanqiu Wu
Diandian Li
Diandian Li
Xiaohua Li
Mei Chen
Hao Wang
Hao Wang
Yongchun Shen
Yongchun Shen
Fuqiang Wen
Fuqiang Wen
Fangying Chen
author_facet Suli Liu
Suli Liu
Yao Yang
Yao Yang
Dongmei Wang
Lijuan Gao
Lijuan Gao
Jiangyue Qin
Jiangyue Qin
Yanqiu Wu
Yanqiu Wu
Diandian Li
Diandian Li
Xiaohua Li
Mei Chen
Hao Wang
Hao Wang
Yongchun Shen
Yongchun Shen
Fuqiang Wen
Fuqiang Wen
Fangying Chen
author_sort Suli Liu
collection DOAJ
description BackgroundDiagnosing tuberculous pleural effusion (TPE) is challenging. There is a lack of cross-sectional lateral comparisons among TPE prediction models.ObjectivesWe aimed to develop and validate a novel TPE prediction model and compare its diagnostic performance with that of existing models.MethodsPatients with pleural effusion were included in the training, testing, and external validation sets. Variable selection strategies included LASSO and logistic regression. The discriminability, calibration, and clinical efficacy of the prediction model were estimated in the three sets. The performance of the model was compared with that of two existing prediction models.ResultsFever, tuberculosis interferon-gamma release assays, pleural adenosine deaminase, the pleural mononuclear cell ratio, the ratio of pleural lactate dehydrogenase to pleural adenosine deaminase, pleural carcinoembryonic antigen, and pleural cytokeratin 19 fragment were selected to establish the prediction model. The AUCs were 0.931 (0.903–0.958), 0.856 (0.753–0.959), and 0.925 (0.867–0.984) in the training, testing, and external validation sets, respectively. The AUCs of the two existing prediction models were 0.793 (0.737–0.850) and 0.854 (0.816–0.892). The calibration curves revealed that this model had good consistency. Decision curve analysis revealed the acceptable clinical benefit of this model.ConclusionCompared with the existing models, the TPE prediction model developed in this study demonstrated good diagnostic performance.
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spelling doaj-art-a3d5efde743943ed9a9de2be0fe184042025-08-20T03:27:27ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-07-011210.3389/fmed.2025.15894061589406Development and validation of a prediction model based on a nomogram for tuberculous pleural effusionSuli Liu0Suli Liu1Yao Yang2Yao Yang3Dongmei Wang4Lijuan Gao5Lijuan Gao6Jiangyue Qin7Jiangyue Qin8Yanqiu Wu9Yanqiu Wu10Diandian Li11Diandian Li12Xiaohua Li13Mei Chen14Hao Wang15Hao Wang16Yongchun Shen17Yongchun Shen18Fuqiang Wen19Fuqiang Wen20Fangying Chen21Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, ChinaState Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, ChinaDivision of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, ChinaState Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, ChinaDivision of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, ChinaState Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, ChinaDivision of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, ChinaState Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, ChinaDivision of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, ChinaState Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, ChinaDivision of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, ChinaState Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Respiratory and Critical Care Medicine, Sixth People’s Hospital of Chengdu, Chengdu, ChinaKey Laboratory of Acupuncture for Senile Disease (Chengdu University of TCM), School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Ministry of Education, Chengdu, ChinaDivision of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, ChinaState Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, ChinaDivision of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, ChinaState Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, ChinaDivision of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, ChinaState Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Tuberculosis, The Third People’s Hospital of Tibet Autonomous Region, Lhasa, ChinaBackgroundDiagnosing tuberculous pleural effusion (TPE) is challenging. There is a lack of cross-sectional lateral comparisons among TPE prediction models.ObjectivesWe aimed to develop and validate a novel TPE prediction model and compare its diagnostic performance with that of existing models.MethodsPatients with pleural effusion were included in the training, testing, and external validation sets. Variable selection strategies included LASSO and logistic regression. The discriminability, calibration, and clinical efficacy of the prediction model were estimated in the three sets. The performance of the model was compared with that of two existing prediction models.ResultsFever, tuberculosis interferon-gamma release assays, pleural adenosine deaminase, the pleural mononuclear cell ratio, the ratio of pleural lactate dehydrogenase to pleural adenosine deaminase, pleural carcinoembryonic antigen, and pleural cytokeratin 19 fragment were selected to establish the prediction model. The AUCs were 0.931 (0.903–0.958), 0.856 (0.753–0.959), and 0.925 (0.867–0.984) in the training, testing, and external validation sets, respectively. The AUCs of the two existing prediction models were 0.793 (0.737–0.850) and 0.854 (0.816–0.892). The calibration curves revealed that this model had good consistency. Decision curve analysis revealed the acceptable clinical benefit of this model.ConclusionCompared with the existing models, the TPE prediction model developed in this study demonstrated good diagnostic performance.https://www.frontiersin.org/articles/10.3389/fmed.2025.1589406/fulltuberculosistuberculous pleural effusionclinical prediction modeldiagnosisnomogram
spellingShingle Suli Liu
Suli Liu
Yao Yang
Yao Yang
Dongmei Wang
Lijuan Gao
Lijuan Gao
Jiangyue Qin
Jiangyue Qin
Yanqiu Wu
Yanqiu Wu
Diandian Li
Diandian Li
Xiaohua Li
Mei Chen
Hao Wang
Hao Wang
Yongchun Shen
Yongchun Shen
Fuqiang Wen
Fuqiang Wen
Fangying Chen
Development and validation of a prediction model based on a nomogram for tuberculous pleural effusion
Frontiers in Medicine
tuberculosis
tuberculous pleural effusion
clinical prediction model
diagnosis
nomogram
title Development and validation of a prediction model based on a nomogram for tuberculous pleural effusion
title_full Development and validation of a prediction model based on a nomogram for tuberculous pleural effusion
title_fullStr Development and validation of a prediction model based on a nomogram for tuberculous pleural effusion
title_full_unstemmed Development and validation of a prediction model based on a nomogram for tuberculous pleural effusion
title_short Development and validation of a prediction model based on a nomogram for tuberculous pleural effusion
title_sort development and validation of a prediction model based on a nomogram for tuberculous pleural effusion
topic tuberculosis
tuberculous pleural effusion
clinical prediction model
diagnosis
nomogram
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1589406/full
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