[论文] Dysphagia Risk Stratification in Head and Neck Cancer via Two-Stage PR...

论文概要

研究领域: ML 作者: Siyuan Zhao, Eric Ababio Anyimadu, Zachary G. Brumm, Yue Ma, Clifton David Fuller, Xinhua Zhang, G. Elisabeta Marai, Guadalupe Canahuate 发布时间: 2026-07-24 arXiv: 2607.22514

中文摘要

吞咽困难是头颈癌(HNC)治疗的一种致残性晚期效应，但在生存护理中及时识别高危患者仍然具有挑战性。确定性评估依赖于视频透视成像，如动态影像吞咽毒性分级(CTCAE-DIGEST)所捕获，虽然经验证，但需要专用设备、训练有素的人员和显著的患者负担，限制了其在监测中的常规使用。相比之下，患者报告结果(PRO)成本低、可扩展，且可在任何临床接触中轻松收集，使其成为识别可能需要进一步评估患者的有吸引力的替代信号。然而，将PRO响应转化为可行动干预的清晰临床框架仍在发展中。特别是，关于患者自我报告的症状负担应在何时提示升级护理仍存在不确定性。本研究通过构建单次就诊PRO-临床预测框架并引入临床可解释的两阶段堆叠模型来解决这一差距，该模型使用PRO响应和结构化临床变量预测吞咽损伤风险，无需视频透视成像。所提出的框架在统一且可解释的风险评估模型中量化了患者报告症状和临床因素的独立贡献。研究结果表明，单个MDADI响应包含超出综合或全局摘要分数捕获的预测信息，而可解释性分析揭示了与吞咽损伤相关的症状模式和临床风险因素。这些结果共同支持将结构化PRO-临床整合作为HNC生存护理中实用的、无需成像的吞咽困难风险分层方法。

原文摘要

Dysphagia is a debilitating late effect of head and neck cancer (HNC) treatment, yet timely identification of at-risk patients remains challenging in survivorship care. Definitive assessment relies on videofluoroscopic imaging, as captured by the Dynamic Imaging Grade of Swallowing Toxicity (CTCAE-DIGEST), which, while validated, requires specialized equipment, trained personnel, and significant patient burden, limiting its routine use in surveillance. Patient-reported outcomes (PROs), by contrast, are low-cost, scalable, and easily collected at any clinical encounter, making them an attractive alternative signal for identifying patients who may warrant further evaluation. However, a clear clinical framework for translating PRO responses into actionable interventions is still evolving. In ...

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