BACKGROUND Barrett's esophagus is the precursor to the highly lethal esophageal adenocarcinoma. Risk prediction models have been developed to assist in its detection, potentially improving early identification and treatment of esophageal adenocarcinoma. Six models have been developed. AIMS To externally validate three models (Rubenstein, Thrift, and Baldwin-Hunter models) and compare them to a fourth risk prediction model (Ireland model) for Barrett's esophagus. METHODS Data from 120 Barrett's cases and 235 population controls were available to externally validate the three models. Discriminatory ability of these models was assessed by the area under the receiver operating characteristic curve. Calibration was assessed with the calibration slope, Hosmer-Lemeshow test, and Lowess smoother calibration plot. Following external validation, diagnostic accuracy of the three models was compared to that of the Ireland model. RESULTS On external validation, the Rubenstein model had an area under the receiver operating characteristic curve of 0.71 and was well calibrated (Hosmer-Lemeshow test, p = 0.67). Likewise, the Thrift and Baldwin-Hunter models had similar discrimination (0.71 and 0.70, respectively) and were also well calibrated (p = 0.69 and p = 0.28). Our previous external validation of the Ireland model provided an area under the receiver operating characteristic curve of 0.83 and was well calibrated (p = 0.14). The Ireland model demonstrated a statistically significantly greater area under the receiver operating characteristic curve than the Rubenstein (p = 0.02), Thrift (p = 0.001), and Baldwin-Hunter (p = 0.002) models. CONCLUSION We externally validated the Rubenstein, Thrift, and Baldwin-Hunter risk prediction models and compared them to the Ireland model. The Ireland model demonstrated improved accuracy, albeit with slightly poorer calibration.

中文翻译：

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Barrett食管的风险预测模型可以很好地区分并且可以在外部验证研究中推广。

背景技术巴雷特食管是高度致死性食管腺癌的前体。已经开发了风险预测模型以帮助其检测，从而可能改善食道腺癌的早期识别和治疗。已经开发了六个模型。目的从外部验证三个模型（Rubenstein，Thrift和Baldwin-Hunter模型），并将它们与Barrett食管的第四个风险预测模型（爱尔兰模型）进行比较。方法来自120个Barrett病例和235个人口对照的数据可用于外部验证这三个模型。通过接收器工作特性曲线下的面积评估这些模型的区分能力。使用校准斜率，Hosmer-Lemeshow测试和Lowess平滑校准图评估校准。经过外部验证，将这三种模型的诊断准确性与爱尔兰模型的诊断准确性进行了比较。结果在外部验证中，鲁宾斯坦模型在接收器工作特性曲线下的面积为0.71，并且已经过很好的校准（Hosmer-Lemeshow测试，p = 0.67）。同样，Thrift模型和Baldwin-Hunter模型具有相似的判别力（分别为0.71和0.70），并且也得到了很好的校准（p = 0.69和p = 0.28）。我们之前对爱尔兰模型的外部验证在接收器工作特性曲线下提供了一个面积为0.83的区域，并进行了很好的校准（p = 0.14）。爱尔兰模型在接收器工作特性曲线下显示出比鲁本斯坦模型（p = 0.02），节俭模型（p = 0.001）和鲍德温-亨特模型（p = 0.002）更大的统计学显着面积。结论我们从外部验证了鲁宾斯坦，Thrift和鲍德温-亨特风险预测模型，并将其与爱尔兰模型进行了比较。尽管校准稍差，但爱尔兰模型显示出更高的准确性。