一项系统回顾与荟萃分析：基于机器学习的儿童哮喘和过敏轨迹分析
2025/03/03
摘要
背景：既往诸多研究应用机器学习描述了儿童哮喘和过敏的轨迹特征，但所用技术及所得结果各不相同。
目的：本研究旨在汇总证据并批判性评价方法学。
方法：本研究共检索10个数据库，成对进行筛选、数据提取和质量评估，并将轨迹特征制成表格并可视化，最后采用随机效应荟萃分析汇总相关风险因素和结果评估。
结果：本研究共纳入89项研究。最常见的疾病轨迹分别为早发（婴儿期）持续型、中发（约2～5年）持续型、早发早期缓解（约2年内）型和早发中期缓解（约3～6年）型喘息和湿疹。间歇型/一过型轨迹少见。男性与大多数喘息轨迹高风险相关，与早期缓解型湿疹可能相关，同时对中发持续型湿疹有轻微保护作用。父母患病史和遗传标记分别与喘息和湿疹的持续型轨迹相关。产前（产后较少）接触烟草烟雾与大多数喘息轨迹有关，婴儿期下呼吸道感染也是如此（尤与早发缓解型相关）。大多数研究（69%）的方法质量较低（尤建模方法和报告方面）。很少有研究涉及过敏性多发病、过敏性鼻炎和食物过敏。
结论：儿童哮喘/喘息和湿疹的特征为一系列相对一致的轨迹，且存在可控风险因素，如出生前/后的烟草暴露。计算方法尚需改进，以提高评估的普适性并阐明间歇型/一过型轨迹的有效性。同样，过敏性多发病、过敏性鼻炎和食物过敏的轨迹亟需进一步阐明。
背景：既往诸多研究应用机器学习描述了儿童哮喘和过敏的轨迹特征，但所用技术及所得结果各不相同。
目的：本研究旨在汇总证据并批判性评价方法学。
方法：本研究共检索10个数据库，成对进行筛选、数据提取和质量评估，并将轨迹特征制成表格并可视化，最后采用随机效应荟萃分析汇总相关风险因素和结果评估。
结果：本研究共纳入89项研究。最常见的疾病轨迹分别为早发（婴儿期）持续型、中发（约2～5年）持续型、早发早期缓解（约2年内）型和早发中期缓解（约3～6年）型喘息和湿疹。间歇型/一过型轨迹少见。男性与大多数喘息轨迹高风险相关，与早期缓解型湿疹可能相关，同时对中发持续型湿疹有轻微保护作用。父母患病史和遗传标记分别与喘息和湿疹的持续型轨迹相关。产前（产后较少）接触烟草烟雾与大多数喘息轨迹有关，婴儿期下呼吸道感染也是如此（尤与早发缓解型相关）。大多数研究（69%）的方法质量较低（尤建模方法和报告方面）。很少有研究涉及过敏性多发病、过敏性鼻炎和食物过敏。
结论：儿童哮喘/喘息和湿疹的特征为一系列相对一致的轨迹，且存在可控风险因素，如出生前/后的烟草暴露。计算方法尚需改进，以提高评估的普适性并阐明间歇型/一过型轨迹的有效性。同样，过敏性多发病、过敏性鼻炎和食物过敏的轨迹亟需进一步阐明。
（中日友好医院呼吸与危重症医学科 张婧媛 摘译 林江涛 审校）
（Eur Respir Rev. 2025 Jan 8;34(175):240160. doi: 10.1183/16000617.0160-2024.）
（Eur Respir Rev. 2025 Jan 8;34(175):240160. doi: 10.1183/16000617.0160-2024.）
Machine learning-derived asthma and allergy trajectories in children: a systematic review and meta-analysis.
Lisik D, Özuygur Ermis SS, Milani GP, Spolidoro GCI, Ercan S, Salisu M, Odetola F, Ghiglioni DG, Pylov D, Goksör E, Basna R, Wennergren G, Kankaanranta H, Nwaru BI.
Abstract
BACKGROUND:Numerous studies have characterised trajectories of asthma and allergy in children using machine learning, but with different techniques and mixed findings.
OBJECTIVES:The present work aimed to summarise the evidence and critically appraise the methodology.
METHODS:10 databases were searched. Screening, data extraction and quality assessment were performed in pairs. Trajectory characteristics were tabulated and visualised. Associated risk factor and outcome estimates were pooled using a random-effects meta-analysis.
RESULTS:89 studies were included. Early-onset (infancy) persistent, mid-onset (∼2-5 years) persistent, early-onset early-resolving (within ∼2 years) and early-onset mid-resolving (by ∼3-6 years) wheezing and eczema, respectively, were the most commonly identified disease trajectories. Intermediate/transient trajectories were rare. Male sex was associated with a higher risk of most wheezing trajectories and possibly with early-resolving eczema, while being slightly protective against mid-onset persistent eczema. Parental disease/genetic markers were associated with persistent trajectories of wheezing and eczema, respectively. Prenatal (and less so postnatal) tobacco smoke exposure was associated with most wheezing trajectories, as were lower respiratory tract infections in infancy (particularly with the early-onset resolving patterns). Most studies (69%) were of low methodological quality (particularly in modelling approaches and reporting). Few studies investigated allergic multimorbidity, allergic rhinitis and food allergy.
CONCLUSION: Childhood asthma/wheezing and eczema can be characterised by a few relatively consistent trajectories, with some actionable risk factors such as pre-/postnatal smoke exposure. Improved computational methodology is warranted to better assess generalisability and elucidate the validity of intermediate/transient trajectories. Likewise, allergic multimorbidity and trajectories of allergic rhinitis and food allergy need to be further elucidated.
Lisik D, Özuygur Ermis SS, Milani GP, Spolidoro GCI, Ercan S, Salisu M, Odetola F, Ghiglioni DG, Pylov D, Goksör E, Basna R, Wennergren G, Kankaanranta H, Nwaru BI.
Abstract
BACKGROUND:Numerous studies have characterised trajectories of asthma and allergy in children using machine learning, but with different techniques and mixed findings.
OBJECTIVES:The present work aimed to summarise the evidence and critically appraise the methodology.
METHODS:10 databases were searched. Screening, data extraction and quality assessment were performed in pairs. Trajectory characteristics were tabulated and visualised. Associated risk factor and outcome estimates were pooled using a random-effects meta-analysis.
RESULTS:89 studies were included. Early-onset (infancy) persistent, mid-onset (∼2-5 years) persistent, early-onset early-resolving (within ∼2 years) and early-onset mid-resolving (by ∼3-6 years) wheezing and eczema, respectively, were the most commonly identified disease trajectories. Intermediate/transient trajectories were rare. Male sex was associated with a higher risk of most wheezing trajectories and possibly with early-resolving eczema, while being slightly protective against mid-onset persistent eczema. Parental disease/genetic markers were associated with persistent trajectories of wheezing and eczema, respectively. Prenatal (and less so postnatal) tobacco smoke exposure was associated with most wheezing trajectories, as were lower respiratory tract infections in infancy (particularly with the early-onset resolving patterns). Most studies (69%) were of low methodological quality (particularly in modelling approaches and reporting). Few studies investigated allergic multimorbidity, allergic rhinitis and food allergy.
CONCLUSION: Childhood asthma/wheezing and eczema can be characterised by a few relatively consistent trajectories, with some actionable risk factors such as pre-/postnatal smoke exposure. Improved computational methodology is warranted to better assess generalisability and elucidate the validity of intermediate/transient trajectories. Likewise, allergic multimorbidity and trajectories of allergic rhinitis and food allergy need to be further elucidated.
上一篇：
没有了
下一篇：
没有了
