呼和浩特市6~14岁儿童注意力缺陷多动障碍预测模型研究

Establishment of a prediction model of ADHD for children aged 6-14 years in Hohhot city

摘要

目的 构建呼和浩特市儿童注意力缺陷多动障碍(ADHD)的预测模型。方法 2023年分层抽样选取呼和浩特市6~14岁3788例儿童作为研究对象,其中临床诊断为ADHD患者的189例为病例组,非ADHD者3599例为对照组,问卷调查儿童及其家庭相关情况,测量其身高和体重相关指标.数据随机分为训练集及测试集,构建预测模型,绘制受试者工作特征(ROC)曲线、校准曲线评价模型的预测能力。结果 在调整性别、年龄因素后,多因素Logistic回归结果显示儿童出生存在宫内窘迫、宫内发育障碍、产程异常、家庭教育方式不当、父母关系不和谐、儿童情绪不稳定时,其发生ADHD的风险增加(OR值介于1.448~1.701之间,P<0.05);儿童ADHD预测模型在训练集中C指数为0.89,测试集中C指数为0.81,ROC曲线下面积(AUC)分别为0.858(0.698~0.952)、0.779(0.631~0.912);训练集和测试集中的校准曲线显示模型预测结果与实际观察结果基本吻合,模型具有较好的区分度和校准度。结论 宫内窘迫、宫内发育障碍、产程异常、家庭教育方式的不当、父母关系不和谐、儿童的情绪不稳定为儿童发生ADHD的危险因素,模型预测效能较好,可作为临床诊断及早期干预的重要参考.

Abstract

Objective To develop a prediction model of attention deficit hyperactivity disorder (ADHD) for children in Hohhot city, Inner Mongolia Autonomous Region in China. Methods In stratified sampling method, 3788 children aged 6-14 years in Hohhot city in 2023 were selected as study subjects. Among them, 189 children were clinically diagnosed as ADHD (case group), and 3599 children without ADHD were selected as controls (control group). A questionnaire was used to investigate family and child-related factors, and physical measurements (height and weight) were recorded. The data was randomly divided into a training set and a testing set. The training set was used to construct a prediction model. Receiver operating characteristic (ROC) curve and calibration curve were drawn to evaluate the model's predictive efficacy. Results Multiple regression analysis shown that after adjusting for gender and age, the following factors were identified as risk factors for occurrence of ADHD in children: intrauterine distress (OR=1.480, 95%CI: 1.214-1.804), intrauterine developmental disorders (OR=1.448, 95%CI: 1.120-1.872), abnormal stages of labor (OR=1.701, 95%CI: 1.219-2.373), inappropriate family education (OR=1.571, 95%CI: 1.190-2.076), parental disharmony (OR=1.452, 95%CI: 1.076-1.960) and emotional instability (OR=1.672, 95%CI: 1.210-2.310). C-indexes of the prediction model in the training set were 0.89 and 0.81 in the testing set. The areas under the curve (AUCs) of ROC curves of the prediction model in the training set and the testing set were 0.858 (95%CI: 0.698-0.952) and 0.779 (95%CI: 0.631-0.912) respectively. The calibration curves for both the training set and the testing set showed that the model's predicted results closely aligned with the actual observed results, suggesting that the prediction model had good discrimination and good calibration. Conclusion Intrauterine distress, intrauterine developmental disorders, abnormal stages of labor, inappropriate family education, parental disharmony and emotional instability are risk factors for ADHD in children. The prediction model has good performance and can serve as an important reference for clinical diagnosis and early intervention of ADHD in children.

关键词

儿童 / 注意力缺陷多动障碍 / 宫内窘迫 / 宫内发育障碍 / 产程异常 / 预测模型

Key words

children / attention-deficit hyperactivity disorder / intrauterine distress / intrauterine developmental disorder / abnormal stages of labor / prediction model

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基金资助

内蒙古自治区科技厅项目(2020GG0139)

内蒙古医科大学面上项目(YKD2022MS071)