Construction of a risk prediction scoring system for tic disorders in Chinese children based on Meta-analysis and external validation

JIANG Yanlin; WANG Junhong; LI Jialin; ZHAI Rui; JIANG Xiulei

doi:10.11852/zgetbjzz2023-1189

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Chinese Journal of Child Health Care ›› 2024, Vol. 32 ›› Issue (10) : 1128-1134. DOI: 10.11852/zgetbjzz2023-1189

Construction of a risk prediction scoring system for tic disorders in Chinese children based on Meta-analysis and external validation

JIANG Yanlin¹, WANG Junhong¹, LI Jialin², ZHAI Rui¹, JIANG Xiulei³

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Abstract

Objective To construct a risk prediction scoring model for tic disorders (TD) in Chinese children using a two-stage approach:Meta-analysis for updated prevalence and risk factors followed by external validation, in order to establish an appropriate predicting model for TD in Chinese children. Methods An extensive search in Chinese and international databases (CNKI, Wanfang, VIP, PubMed, Embase, Web of Science) was conducted to identify observational studies on TD prevalence and risk factors in Chinese children published before October 2022.Meta-analysis in R yielded updated prevalence estimates and pooled odds ratios (ORs) for risk factors.A risk prediction model was developed using Logistic regression based on these findings.A total of 644 children (TD patients and healthy controls) from Dongzhimen Hospital, Beijing, from October 2022 to June 2023 were recruited for model validation.Predictive performance was assessed by the area under the receiver operating characteristic (ROC) curve (AUC) and clinical utility via decision curve analysis. Results Finally 34 studies were included in this Meta-analysis, encompassing 9 955 patients.The overall prevalence of TD in Chinese children diagnosed using DSM-IV criteria was 1.22% (95%CI:0.79% - 1.86%).After filtering, eight risk factors were incorporated into the model, including psychiatric abnormality during pregnancy (OR=2.50, 95%CI:1.78 - 3.52), other perinatal factors (OR=3.05, 95%CI:2.21 - 4.21), recurrent respiratory infections (OR=2.51, 95%CI:2.12 - 2.97), family history of TD (OR=4.86, 95%CI:2.98 - 7.93), corporal punishment (OR=2.78, 95%CI:1.73 - 4.47), poor dietary habits (OR=2.27, 95%CI:1.50 - 3.42), excessive screen time (OR=2.29, 95%CI:1.91-2.73), and single-parent/left-behind child/family disharmony (OR=2.44, 95%CI:1.53 - 3.89).The model score ranged from 0 to 80, with an AUC of 0.726 (95%CI:0.675 - 0.776).The optimal cutoff was 11 points, yielding 65.4% sensitivity and 70% specificity.The model demonstrated significant clinical net benefit within a 10% - 40% probability threshold. Conclusions This TD risk prediction scoring system based on Meta-analysis shows promising performance as a clinical assessment tool.However, further validation and refinement are warranted.

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tic disorders / Meta-analysis / Logistic regression / risk prediction model

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JIANG Yanlin, WANG Junhong, LI Jialin, ZHAI Rui, JIANG Xiulei. Construction of a risk prediction scoring system for tic disorders in Chinese children based on Meta-analysis and external validation[J]. Chinese Journal of Child Health Care. 2024, 32(10): 1128-1134 https://doi.org/10.11852/zgetbjzz2023-1189

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