{
  "abstract": "Background: Persistent post-prostatectomy urinary incontinence (PPI) is a survivorship problem after radical prostatectomy with continuing implications for daily function, rehabilitation, follow-up, and supportive care. Risk stratification could help target these services, but uncommon events constrain model complexity and require evaluation beyond discrimination.\n\nObjective: To develop a perioperative model for PPI 12 months after catheter removal using LASSO-penalized logistic regression, compare it with a constrained gradient boosting machine (GBM), and examine temporal performance in a later same-center cohort.\n\nMethods: The development cohort comprised 726 patients with 51 PPI events (7.0%) and 19 candidate predictors. LASSO tuning used the one-standard-error rule within resampling, and the strategies were compared by nested repeated stratified five-fold cross-validation. The selected LASSO model was refitted to the full development cohort and applied without coefficient updating or recalibration to 465 later patients with 38 events (8.2%). Evaluation included ROC-AUC, average precision, Brier score, calibration-in-the-large (CITL), calibration slope, threshold-dependent measures, and decision-curve analysis.\n\nResults: Eight original predictors were retained: age, preoperative International Prostate Symptom Score, ln(1 + prostate-specific antigen), operative time, postoperative hospital stay, smoking history, hypertension, and neurovascular bundle preservation. Nested internal validation yielded a ROC-AUC of 0.913 (95% CI 0.871–0.946), average precision of 0.542 (0.404–0.675), and Brier score of 0.046 (0.035–0.058) for LASSO, versus 0.896, 0.488, and 0.048 for constrained GBM. In the temporal cohort, ROC-AUC was 0.836 (0.763–0.900), average precision 0.409 (0.277–0.564), and Brier score 0.062 (0.045–0.081). CITL was 0.445 (0.012–0.808) and the calibration slope 0.850 (0.621–1.174), indicating average underprediction. At the development-derived threshold of 0.128, sensitivity was 0.500 and specificity 0.913. Decision-curve analysis indicated potential net benefit across thresholds of 2–30%.\n\nConclusion: The LASSO model retained useful temporal discrimination but underestimated absolute risk, and the development-derived cutoff did not transport well. It is therefore better suited to continuous risk estimation for survivorship follow-up and rehabilitation planning than to a fixed binary triage rule. Independent geographic validation, local calibration assessment, and prospective evaluation of clinical impact are required before routine use.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Urology, The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine",
    "Department of Urology, Guiyang First People’s Hospital"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Lang Tang"
    },
    {
      "affs": [
        1
      ],
      "name": "Ming Hao"
    },
    {
      "affs": [
        0
      ],
      "name": "Mengru Luo"
    },
    {
      "affs": [
        0
      ],
      "name": "Shizhu Li"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9941tp26csmx1.bib",
  "cited_by": 0,
  "doi": "10.3389/fpubh.2026.1968281",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13730860/",
  "id": "9941tp26csmx1",
  "issns": [
    "2296-2565"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fpubh.2026.1968281/full",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2740|Prostate Cancer Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7223116595",
  "pdf_url": "https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1968281/pdf",
  "pmcid": "PMC13730860",
  "pmid": "42984545",
  "published": "2026-10-21",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/9941tp26csmx1.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:24Z",
      "native_id": "10.3389/fpubh.2026.1968281",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fpubh.2026.1968281/full"
    },
    {
      "first_seen": "2026-11-07T12:23:50Z",
      "native_id": "PMC13730860",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fpubh.2026.1968281"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2296-2565",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Risk prediction for 12-month post-prostatectomy urinary incontinence to support survivorship care: development and same-center temporal validation of a perioperative model",
  "title_text": "Risk prediction for 12-month post-prostatectomy urinary incontinence to support survivorship care: development and same-center temporal validation of a perioperative model",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:21:10Z",
  "url": "https://research.draconitic.com/paper/9941tp26csmx1",
  "venue": "Frontiers in Public Health",
  "versions": []
}