1.Multicenter machine learning-based construction of a model for predicting potential organ donors and validation with decision curve analysis
Xu WANG ; Wenxiu LI ; Fenghua WANG ; Shuli WU ; Dong JIA ; Xin GE ; Zhihua SHAN ; Tongzuo LI
Organ Transplantation 2026;17(1):106-115
Objective To evaluate the predictive value of different machine learning models constructed in a multicenter environment for potential organ donors and verify their clinical application feasibility. Methods The study included 2 000 inpatients admitted to five domestic tertiary hospitals from January 2020 to December 2023, who met the criteria for potential organ donation assessment. They were randomly divided into a training set and an internal validation set (7∶3). Another 300 similar patients admitted to the First Affiliated Hospital of Harbin Medical University from January 2024 to April 2025 were included as an external validation set. The area under the curve (AUC), sensitivity, specificity, accuracy and F1-score of three models were compared, and the consistency of the potential organ donor determination process was tested. Multivariate logistic regression analysis was used to identify predictive factors of potential organ donors. Decision curve analysis (DCA) was employed to verify the resource efficiency of each model, and the threshold interval and intervention balance point were assessed. Results Apart from age, there were no significant differences in other basic characteristics among the centers (all P>0.05). The consistency of the potential organ donor determination process among researchers in each center was good [all 95% confidence interval (CI) lower limits >0]. In the internal validation set, the XGBoost model had the best predictive performance (AUC=0.92, 95% CI 0.89-0.94) and the best calibration (P=0.441, Brier score 0.099). In the external validation set, the XGBoost model also had the best predictive performance (AUC=0.91, 95% CI 0.88-0.94), outperforming logistic regression and random forest models. Multivariate logistic regression showed that mechanical ventilation had the greatest impact (odds ratio=2.06, 95% CI 1.54-2.76, P<0.001). DCA indicated that the XGBoost model had the highest net benefit in the threshold interval of 0.2-0.6. The “treat all” strategy only had a slight advantage at extremely low thresholds. The recommended threshold interval, which balances intervention costs and clinical benefits, considers ≥50% positive predictive value (PPV) and ≤50 referrals per 100 high-risk patients. Conclusions The XGBoost model established in a multicenter environment is accurate and well-calibrated in predicting potential organ donors. Combined with DCA, it may effectively guide the timing of clinical interventions and resource allocation, providing new ideas for the assessment and management of organ donation after brain death.
2.Effect of Jiuxin Pill (救心丸)on Exercise Tolerance and Quality of Life in Patients of Stable Angina Pectoris:A Randomized,Double-Blind,Placebo-Controlled,Multi-Center Clinical Trial
Xianliang WANG ; Mingjun ZHU ; Daimei NI ; Jianguang WU ; Yitao XUE ; Chenglong WANG ; Xiaohua DAI ; Qian LIN ; Jun LI ; Zhiqiang ZHAO ; Shuai WANG ; Yingfei BI ; Tongzuo LIU ; Zhou ZHOU ; Jingyuan MAO
Journal of Traditional Chinese Medicine 2024;65(24):2549-2557
ObjectiveTo evaluate the effect and safety of Jiuxin Pill (救心丸) on exercise tolerance and quality of life in patients with stable angina pectoris (SAP). MethodsA randomised, double-blind, placebo-controlled, multicentre study design was used to enroll 170 patients of SAP from nine centres, which were divided into 85 patients each in the trial group and control group with 1∶1 ratio. Both groups maintained the original western medicine treatment plan, and added Jiuxin Pill or placebo respectively, 2 pills (0.05 g) each time twicely for 28 days. The main outcomes were total exercise time (TED) in the exercise treadmill test and Seattle Angina Questionnaire (SAQ) scores including physical limitation (PL), angina stability (AS), angina frequency (AF), treatment satisfaction (TS), and disease perception (DP). The secondary outcomes were exercise treadmill test indicators including heart rate recovery in 1 min (HRR1), metabolic equivalents (METs), maximum magnitude of ST-segment depression, and the Borg rating of perceived exertion scale, the average number of angina attacks per week, withdrawal and reduction rate of nitroglycerin, traditional Chinese medicine syndrome scores, incidence of major adverse cardiovascular events. Safety indicators were evaluated and the occurrence of adverse events during the trial was recorded. Data was collected before treatment, day 28±2 in treatment period, and follow-up at day 56 which is 28±2 days after treatment period finished. ResultsEighty-four and eighty-five patients respectively from trial group and control group were included to the full analysis set (FAS) and safety analysis set (SS). Compared with the group before treatment and with the control group after treatment, the trial group had higher TED, HRR1, and METs, and lower maximum magnitude of ST-segment depression and Borg rating of perceived exertion scores after treatment (P<0.01). Compared with the group before treatment and with the control group after treatment and at follow-up, the total SAQ score and scores of AS, AF, TS and DP of the trial group after treatment and at follow-up elevated, while the average number of angina attacks per week and traditional Chinese medicine syndrome scores reduced (P<0.01). There was no statistically significant difference in the withdrawal and reduction rate of nitroglycerin between groups (P>0.05). Major adverse cardiovascular events occurred in 1 case (1/84, 1.19%) in the trial group and 1 case (1/85, 1.18%) in the control group, and the difference between groups was not statistically significant (P>0.05). A total of 3 cases of adverse events occurred in the trial group (3/84, 3.57%), and a total of 6 cases of adverse events occurred in the control group (6/85, 7.06%), and there was no statistically significant difference in the incidence of adverse events between groups (P>0.05). ConclusionIn the treatment of SAP, Jiuxin Pill combined with conventional western medicine can further enhance exercise tolerance, improve quality of life, and demonstrate great safety.
3.Analysis of the effect of Using DRG Index to Improve The Professional Ability of Doctors in a Hospital/
Wenxiang TANG ; Yu PAN ; Tongzuo LI
Chinese Hospital Management 2024;44(9):61-63
Objective Using Disease Diagnosis Related Grouping(DRG)index to assess the professional compe-tence of physicians in the evaluation of health professional and technical titles,and analysing their effectiveness.Methods The DRG indexes of 1 184 physicians were statistically analyzed before and after the implementation of DRG promotion policy.After normal test,Wilcoxon rank sum test was used to compare the CMI,number of DRG groups,total weight,time consumption index and cost consumption index of 1184 physicians in a hospital before and after applying DRG index to assess individual ability.Results The study found that after the introduction of DRG in-dex,CMI,number of DRG groups and total weight of physicians all showed an increasing trend,in which CMI in-creased from 1.17 to 1.20,time consumption index decreased,cost consumption index had no statistical signifi-cance(P>0.05),and the difficulty of hospital treatment and medical efficiency improved.Conclusion The use of DRG index to assess doctors'professional ability has a positive effect on hospitals,which can improve the quality of diagnosis and treatment,improve efficiency,optimize patient grouping and medical division.DRG index can be used as a tool to assess doctors'professional ability.
4.Analysis of the effect of Using DRG Index to Improve The Professional Ability of Doctors in a Hospital/
Wenxiang TANG ; Yu PAN ; Tongzuo LI
Chinese Hospital Management 2024;44(9):61-63
Objective Using Disease Diagnosis Related Grouping(DRG)index to assess the professional compe-tence of physicians in the evaluation of health professional and technical titles,and analysing their effectiveness.Methods The DRG indexes of 1 184 physicians were statistically analyzed before and after the implementation of DRG promotion policy.After normal test,Wilcoxon rank sum test was used to compare the CMI,number of DRG groups,total weight,time consumption index and cost consumption index of 1184 physicians in a hospital before and after applying DRG index to assess individual ability.Results The study found that after the introduction of DRG in-dex,CMI,number of DRG groups and total weight of physicians all showed an increasing trend,in which CMI in-creased from 1.17 to 1.20,time consumption index decreased,cost consumption index had no statistical signifi-cance(P>0.05),and the difficulty of hospital treatment and medical efficiency improved.Conclusion The use of DRG index to assess doctors'professional ability has a positive effect on hospitals,which can improve the quality of diagnosis and treatment,improve efficiency,optimize patient grouping and medical division.DRG index can be used as a tool to assess doctors'professional ability.
5.Analysis of the effect of Using DRG Index to Improve The Professional Ability of Doctors in a Hospital/
Wenxiang TANG ; Yu PAN ; Tongzuo LI
Chinese Hospital Management 2024;44(9):61-63
Objective Using Disease Diagnosis Related Grouping(DRG)index to assess the professional compe-tence of physicians in the evaluation of health professional and technical titles,and analysing their effectiveness.Methods The DRG indexes of 1 184 physicians were statistically analyzed before and after the implementation of DRG promotion policy.After normal test,Wilcoxon rank sum test was used to compare the CMI,number of DRG groups,total weight,time consumption index and cost consumption index of 1184 physicians in a hospital before and after applying DRG index to assess individual ability.Results The study found that after the introduction of DRG in-dex,CMI,number of DRG groups and total weight of physicians all showed an increasing trend,in which CMI in-creased from 1.17 to 1.20,time consumption index decreased,cost consumption index had no statistical signifi-cance(P>0.05),and the difficulty of hospital treatment and medical efficiency improved.Conclusion The use of DRG index to assess doctors'professional ability has a positive effect on hospitals,which can improve the quality of diagnosis and treatment,improve efficiency,optimize patient grouping and medical division.DRG index can be used as a tool to assess doctors'professional ability.
6.Analysis of the effect of Using DRG Index to Improve The Professional Ability of Doctors in a Hospital/
Wenxiang TANG ; Yu PAN ; Tongzuo LI
Chinese Hospital Management 2024;44(9):61-63
Objective Using Disease Diagnosis Related Grouping(DRG)index to assess the professional compe-tence of physicians in the evaluation of health professional and technical titles,and analysing their effectiveness.Methods The DRG indexes of 1 184 physicians were statistically analyzed before and after the implementation of DRG promotion policy.After normal test,Wilcoxon rank sum test was used to compare the CMI,number of DRG groups,total weight,time consumption index and cost consumption index of 1184 physicians in a hospital before and after applying DRG index to assess individual ability.Results The study found that after the introduction of DRG in-dex,CMI,number of DRG groups and total weight of physicians all showed an increasing trend,in which CMI in-creased from 1.17 to 1.20,time consumption index decreased,cost consumption index had no statistical signifi-cance(P>0.05),and the difficulty of hospital treatment and medical efficiency improved.Conclusion The use of DRG index to assess doctors'professional ability has a positive effect on hospitals,which can improve the quality of diagnosis and treatment,improve efficiency,optimize patient grouping and medical division.DRG index can be used as a tool to assess doctors'professional ability.
7.Analysis of the effect of Using DRG Index to Improve The Professional Ability of Doctors in a Hospital/
Wenxiang TANG ; Yu PAN ; Tongzuo LI
Chinese Hospital Management 2024;44(9):61-63
Objective Using Disease Diagnosis Related Grouping(DRG)index to assess the professional compe-tence of physicians in the evaluation of health professional and technical titles,and analysing their effectiveness.Methods The DRG indexes of 1 184 physicians were statistically analyzed before and after the implementation of DRG promotion policy.After normal test,Wilcoxon rank sum test was used to compare the CMI,number of DRG groups,total weight,time consumption index and cost consumption index of 1184 physicians in a hospital before and after applying DRG index to assess individual ability.Results The study found that after the introduction of DRG in-dex,CMI,number of DRG groups and total weight of physicians all showed an increasing trend,in which CMI in-creased from 1.17 to 1.20,time consumption index decreased,cost consumption index had no statistical signifi-cance(P>0.05),and the difficulty of hospital treatment and medical efficiency improved.Conclusion The use of DRG index to assess doctors'professional ability has a positive effect on hospitals,which can improve the quality of diagnosis and treatment,improve efficiency,optimize patient grouping and medical division.DRG index can be used as a tool to assess doctors'professional ability.
8.Analysis of the effect of Using DRG Index to Improve The Professional Ability of Doctors in a Hospital/
Wenxiang TANG ; Yu PAN ; Tongzuo LI
Chinese Hospital Management 2024;44(9):61-63
Objective Using Disease Diagnosis Related Grouping(DRG)index to assess the professional compe-tence of physicians in the evaluation of health professional and technical titles,and analysing their effectiveness.Methods The DRG indexes of 1 184 physicians were statistically analyzed before and after the implementation of DRG promotion policy.After normal test,Wilcoxon rank sum test was used to compare the CMI,number of DRG groups,total weight,time consumption index and cost consumption index of 1184 physicians in a hospital before and after applying DRG index to assess individual ability.Results The study found that after the introduction of DRG in-dex,CMI,number of DRG groups and total weight of physicians all showed an increasing trend,in which CMI in-creased from 1.17 to 1.20,time consumption index decreased,cost consumption index had no statistical signifi-cance(P>0.05),and the difficulty of hospital treatment and medical efficiency improved.Conclusion The use of DRG index to assess doctors'professional ability has a positive effect on hospitals,which can improve the quality of diagnosis and treatment,improve efficiency,optimize patient grouping and medical division.DRG index can be used as a tool to assess doctors'professional ability.
9.Analysis of the effect of Using DRG Index to Improve The Professional Ability of Doctors in a Hospital/
Wenxiang TANG ; Yu PAN ; Tongzuo LI
Chinese Hospital Management 2024;44(9):61-63
Objective Using Disease Diagnosis Related Grouping(DRG)index to assess the professional compe-tence of physicians in the evaluation of health professional and technical titles,and analysing their effectiveness.Methods The DRG indexes of 1 184 physicians were statistically analyzed before and after the implementation of DRG promotion policy.After normal test,Wilcoxon rank sum test was used to compare the CMI,number of DRG groups,total weight,time consumption index and cost consumption index of 1184 physicians in a hospital before and after applying DRG index to assess individual ability.Results The study found that after the introduction of DRG in-dex,CMI,number of DRG groups and total weight of physicians all showed an increasing trend,in which CMI in-creased from 1.17 to 1.20,time consumption index decreased,cost consumption index had no statistical signifi-cance(P>0.05),and the difficulty of hospital treatment and medical efficiency improved.Conclusion The use of DRG index to assess doctors'professional ability has a positive effect on hospitals,which can improve the quality of diagnosis and treatment,improve efficiency,optimize patient grouping and medical division.DRG index can be used as a tool to assess doctors'professional ability.
10.Analysis of the effect of Using DRG Index to Improve The Professional Ability of Doctors in a Hospital/
Wenxiang TANG ; Yu PAN ; Tongzuo LI
Chinese Hospital Management 2024;44(9):61-63
Objective Using Disease Diagnosis Related Grouping(DRG)index to assess the professional compe-tence of physicians in the evaluation of health professional and technical titles,and analysing their effectiveness.Methods The DRG indexes of 1 184 physicians were statistically analyzed before and after the implementation of DRG promotion policy.After normal test,Wilcoxon rank sum test was used to compare the CMI,number of DRG groups,total weight,time consumption index and cost consumption index of 1184 physicians in a hospital before and after applying DRG index to assess individual ability.Results The study found that after the introduction of DRG in-dex,CMI,number of DRG groups and total weight of physicians all showed an increasing trend,in which CMI in-creased from 1.17 to 1.20,time consumption index decreased,cost consumption index had no statistical signifi-cance(P>0.05),and the difficulty of hospital treatment and medical efficiency improved.Conclusion The use of DRG index to assess doctors'professional ability has a positive effect on hospitals,which can improve the quality of diagnosis and treatment,improve efficiency,optimize patient grouping and medical division.DRG index can be used as a tool to assess doctors'professional ability.

Result Analysis
Print
Save
E-mail