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. 2021 Jul;35(7):e23820.
doi: 10.1002/jcla.23820. Epub 2021 Jun 14.

A dynamic nomogram for predicting the risk of asthma: Development and validation in a database study

Lifen Yang  1   2 , Meihua Li  1   2 , Qinling Zheng  1   2 , Chaofeng Ren  1   2 , Wei Ma  1   2 , Yanxia Yang  1   2
Affiliations

A dynamic nomogram for predicting the risk of asthma: Development and validation in a database study

Lifen Yang et al. J Clin Lab Anal. 2021 Jul.

Abstract

Background: Asthma remains a serious health problem with increasing prevalence and incidence. This study was to develop and validate a dynamic nomogram for predicting asthma risk.

Methods: Totally 597 subjects whose age ≥18 years old with asthma, an accurate age at first cigarette, and clear smoking status were selected from the National Health and Nutrition Examination Survey (NHANES) database (2013-2018). The dataset was randomly split into the training set and the testing set at a ratio of 4:6. Simple and multiple logistic regressions were used for identifying independent predictors. Then the nomogram was developed and internally validated using data from the testing set. The receiver operator characteristic (ROC) curve was used for assessing the performance of the nomogram.

Results: According to the simple and multiple logistic regressions, smoking ≥40 years, female gender, the age for the first smoking, having close relative with asthma were independently associated with the risk of an asthma attack. The nomogram was thereby developed with the link of https://yanglifen.shinyapps.io/Dynamic_Nomogram_for_Asthma/. The ROC analyses showed an AUC of 0.726 (0.724-0.728) with a sensitivity of 0.887 (0.847-0.928) in the training set, and an AUC of 0.702 (0.700-0.703) with a sensitivity of 0.860 (0.804-0.916) in the testing set, fitting well in calibration curves. Decision curve analysis further confirmed the clinical usefulness of the nomogram.

Conclusion: Our dynamic nomogram could help clinicians to assess the individual probability of asthma attack, which was helpful for improving the treatment and prognosis of asthma.

Keywords: NHANES database; asthma; dynamic nomogram; smoking duration.

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Conflict of interest statement

There is no conflict of interest in this work.

Figures

FIGURE 1
FIGURE 1
Multiple logistic regression of the training set
FIGURE 2
FIGURE 2
RCS for smoking duration and asthma risk
FIGURE 3
FIGURE 3
RCS for age for first asthma attack and asthma risk
FIGURE 4
FIGURE 4
ROC curves of the training set and the testing set
FIGURE 5
FIGURE 5
Interface of the dynamic nomogram
FIGURE 6
FIGURE 6
Decision curve for the nomogram
FIGURE 7
FIGURE 7
Calibration curve for the nomogram
See this image and copyright information in PMC

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