Clinical nomogram assisting in discrimination of juvenile dermatomyositis-associated interstitial lung disease

Respir Res. 2023 Nov 16;24(1):286. doi: 10.1186/s12931-023-02599-9.

Abstract

Objective: To establish a prediction model using non-invasive clinical features for early discrimination of DM-ILD in clinical practice.

Method: Clinical data of pediatric patients with JDM were retrospectively analyzed using machine learning techniques. The early discrimination model for JDM-ILD was established within a patient cohort diagnosed with JDM at a children's hospital between June 2015 and October 2022.

Results: A total of 93 children were included in the study, with the cohort divided into a discovery cohort (n = 58) and a validation cohort (n = 35). Univariate and multivariate analyses identified factors associated with JDM-ILD, including higher ESR (OR, 3.58; 95% CI 1.21-11.19, P = 0.023), higher IL-10 levels (OR, 1.19; 95% CI, 1.02-1.41, P = 0.038), positivity for MDA-5 antibodies (OR, 5.47; 95% CI, 1.11-33.43, P = 0.045). A nomogram was developed for risk prediction, demonstrating favorable discrimination in both the discovery cohort (AUC, 0.736; 95% CI, 0.582-0.868) and the validation cohort (AUC, 0.792; 95% CI, 0.585-0.930). Higher nomogram scores were significantly associated with an elevated risk of disease progression in both the discovery cohort (P = 0.045) and the validation cohort (P = 0.017).

Conclusion: The nomogram based on the ESIM predictive model provides valuable guidance for the clinical evaluation and long-term prognosis prediction of JDM-ILD.

Keywords: Diagnosis; nomogram; Interstitial lung Disease; Juvenile dermatomyositis.

MeSH terms

  • Child
  • Dermatomyositis* / complications
  • Dermatomyositis* / diagnosis
  • Dermatomyositis* / epidemiology
  • Humans
  • Lung Diseases, Interstitial* / complications
  • Lung Diseases, Interstitial* / diagnosis
  • Lung Diseases, Interstitial* / epidemiology
  • Nomograms
  • Prognosis
  • Retrospective Studies