An internally validated prognostic model for success in revision stapes surgery for otosclerosis

Inge Wegner, Robert Vincent, Laura S. M. Derks, Simone P. Rauh, Martijn W. Heymans, Inge Stegeman, Wilko Grolman

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objectives/Hypothesis: To develop a prediction model that can accurately predict the chance of success following revision stapes surgery in patients with recurrent or persistent otosclerosis at 2- to 6-months follow-up and to validate this model internally. Study Design: A retrospective cohort study of prospectively gathered data in a tertiary referral center. Methods: The associations of 11 prognostic factors with treatment success were tested in 705 cases using multivariable logistic regression analysis with backward selection. Success was defined as a mean air-bone gap closure to 10 dB or less. The most relevant predictors were used to derive a clinical prediction rule to determine the probability of success. Internal validation by means of bootstrapping was performed. Model performance indices, including the Hosmer-Lemeshow test, the area under the receiver operating characteristics curve (AUC), and the explained variance were calculated. Results: Success was achieved in 57.7% of cases at 2- to 6-months follow-up. Certain previous surgical techniques, primary causes of failure leading up to revision stapes surgery, and positions of the prosthesis placed during revision surgery were associated with higher success percentages. The clinical prediction rule performed moderately well in the original dataset (Hosmer-Lemeshow P =.78; AUC = 0.73; explained variance = 22%), which slightly decreased following internal validation by means of bootstrapping (AUC = 0.69; explained variance = 13%). Conclusions: Our study established the importance of previous surgical technique, primary cause of failure, and type of the prosthesis placed during the revision surgery in predicting the probability of success following stapes surgery at 2- to 6-months follow-up. Level of Evidence: 2b. Laryngoscope, 128:2390–2396, 2018.
Original languageEnglish
Pages (from-to)2390-2396
JournalLaryngoscope
Volume128
Issue number10
DOIs
Publication statusPublished - 2018

Cite this

Wegner, Inge ; Vincent, Robert ; Derks, Laura S. M. ; Rauh, Simone P. ; Heymans, Martijn W. ; Stegeman, Inge ; Grolman, Wilko. / An internally validated prognostic model for success in revision stapes surgery for otosclerosis. In: Laryngoscope. 2018 ; Vol. 128, No. 10. pp. 2390-2396.
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title = "An internally validated prognostic model for success in revision stapes surgery for otosclerosis",
abstract = "Objectives/Hypothesis: To develop a prediction model that can accurately predict the chance of success following revision stapes surgery in patients with recurrent or persistent otosclerosis at 2- to 6-months follow-up and to validate this model internally. Study Design: A retrospective cohort study of prospectively gathered data in a tertiary referral center. Methods: The associations of 11 prognostic factors with treatment success were tested in 705 cases using multivariable logistic regression analysis with backward selection. Success was defined as a mean air-bone gap closure to 10 dB or less. The most relevant predictors were used to derive a clinical prediction rule to determine the probability of success. Internal validation by means of bootstrapping was performed. Model performance indices, including the Hosmer-Lemeshow test, the area under the receiver operating characteristics curve (AUC), and the explained variance were calculated. Results: Success was achieved in 57.7{\%} of cases at 2- to 6-months follow-up. Certain previous surgical techniques, primary causes of failure leading up to revision stapes surgery, and positions of the prosthesis placed during revision surgery were associated with higher success percentages. The clinical prediction rule performed moderately well in the original dataset (Hosmer-Lemeshow P =.78; AUC = 0.73; explained variance = 22{\%}), which slightly decreased following internal validation by means of bootstrapping (AUC = 0.69; explained variance = 13{\%}). Conclusions: Our study established the importance of previous surgical technique, primary cause of failure, and type of the prosthesis placed during the revision surgery in predicting the probability of success following stapes surgery at 2- to 6-months follow-up. Level of Evidence: 2b. Laryngoscope, 128:2390–2396, 2018.",
author = "Inge Wegner and Robert Vincent and Derks, {Laura S. M.} and Rauh, {Simone P.} and Heymans, {Martijn W.} and Inge Stegeman and Wilko Grolman",
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An internally validated prognostic model for success in revision stapes surgery for otosclerosis. / Wegner, Inge; Vincent, Robert; Derks, Laura S. M.; Rauh, Simone P.; Heymans, Martijn W.; Stegeman, Inge; Grolman, Wilko.

In: Laryngoscope, Vol. 128, No. 10, 2018, p. 2390-2396.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - An internally validated prognostic model for success in revision stapes surgery for otosclerosis

AU - Wegner, Inge

AU - Vincent, Robert

AU - Derks, Laura S. M.

AU - Rauh, Simone P.

AU - Heymans, Martijn W.

AU - Stegeman, Inge

AU - Grolman, Wilko

PY - 2018

Y1 - 2018

N2 - Objectives/Hypothesis: To develop a prediction model that can accurately predict the chance of success following revision stapes surgery in patients with recurrent or persistent otosclerosis at 2- to 6-months follow-up and to validate this model internally. Study Design: A retrospective cohort study of prospectively gathered data in a tertiary referral center. Methods: The associations of 11 prognostic factors with treatment success were tested in 705 cases using multivariable logistic regression analysis with backward selection. Success was defined as a mean air-bone gap closure to 10 dB or less. The most relevant predictors were used to derive a clinical prediction rule to determine the probability of success. Internal validation by means of bootstrapping was performed. Model performance indices, including the Hosmer-Lemeshow test, the area under the receiver operating characteristics curve (AUC), and the explained variance were calculated. Results: Success was achieved in 57.7% of cases at 2- to 6-months follow-up. Certain previous surgical techniques, primary causes of failure leading up to revision stapes surgery, and positions of the prosthesis placed during revision surgery were associated with higher success percentages. The clinical prediction rule performed moderately well in the original dataset (Hosmer-Lemeshow P =.78; AUC = 0.73; explained variance = 22%), which slightly decreased following internal validation by means of bootstrapping (AUC = 0.69; explained variance = 13%). Conclusions: Our study established the importance of previous surgical technique, primary cause of failure, and type of the prosthesis placed during the revision surgery in predicting the probability of success following stapes surgery at 2- to 6-months follow-up. Level of Evidence: 2b. Laryngoscope, 128:2390–2396, 2018.

AB - Objectives/Hypothesis: To develop a prediction model that can accurately predict the chance of success following revision stapes surgery in patients with recurrent or persistent otosclerosis at 2- to 6-months follow-up and to validate this model internally. Study Design: A retrospective cohort study of prospectively gathered data in a tertiary referral center. Methods: The associations of 11 prognostic factors with treatment success were tested in 705 cases using multivariable logistic regression analysis with backward selection. Success was defined as a mean air-bone gap closure to 10 dB or less. The most relevant predictors were used to derive a clinical prediction rule to determine the probability of success. Internal validation by means of bootstrapping was performed. Model performance indices, including the Hosmer-Lemeshow test, the area under the receiver operating characteristics curve (AUC), and the explained variance were calculated. Results: Success was achieved in 57.7% of cases at 2- to 6-months follow-up. Certain previous surgical techniques, primary causes of failure leading up to revision stapes surgery, and positions of the prosthesis placed during revision surgery were associated with higher success percentages. The clinical prediction rule performed moderately well in the original dataset (Hosmer-Lemeshow P =.78; AUC = 0.73; explained variance = 22%), which slightly decreased following internal validation by means of bootstrapping (AUC = 0.69; explained variance = 13%). Conclusions: Our study established the importance of previous surgical technique, primary cause of failure, and type of the prosthesis placed during the revision surgery in predicting the probability of success following stapes surgery at 2- to 6-months follow-up. Level of Evidence: 2b. Laryngoscope, 128:2390–2396, 2018.

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UR - https://www.ncbi.nlm.nih.gov/pubmed/29520797

U2 - 10.1002/lary.27132

DO - 10.1002/lary.27132

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SP - 2390

EP - 2396

JO - Laryngoscope

JF - Laryngoscope

SN - 0023-852X

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