Multimodal prediction of documented 1-year asthma exacerbation risk incorporating a static baseline CT digital-twin framework: a retrospective cohort study
6 affiliations
- 1Department of Geriatric and Special Needs Medicine Integrated Ward, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
- 2Department of Pulmonary and Critical Care Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
- 3Department of Pulmonary and Critical Care Medicine, Wuzhong People's Hospital, Wuzhong, Ningxia, China
- 4Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
- 5Department of Clinical Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- 6Department of Medical Sciences, Medical Laboratory of Innovation and Education Co., Ltd., Changsha, Hunan, China
Abstract
BackgroundTo develop and conditionally evaluate a multimodal prediction model incorporating a static baseline CT digital-twin framework for documented 1-year asthma exacerbation risk.MethodsThis retrospective single-center study analyzed 505 adults with asthma. Baseline three-dimensional CT reconstruction supplied quantitative features; the static baseline CT digital-twin framework did not simulate physiology or update dynamically. A LASSO-selected 10-variable logistic score was evaluated using nested domain comparisons, calibration, Brier score, and 1,000 bootstrap refits conditional on the selected predictor set. An available-variable clinical comparator was evaluated with and without CT features.ResultsSeventy-two patients (14.3%) had a documented exacerbation. The final score had apparent AUC 0.880 (conditional bootstrap 95% CI, 0.836–0.917) and Brier score 0.086. Fixed-predictor bootstrap correction yielded AUC 0.856, calibration slope 0.875, intercept −0.182, and Brier score 0.094, without accounting for the original variable-selection step. CT increased AUC from 0.880 to 0.894 in the fully nested comparison (likelihood-ratio P = 0.070), and from 0.725 to 0.774 in the available-variable comparator (P < 0.001). These were apparent, exploratory comparisons, not external validation.ConclusionThe multimodal score showed conditional internal performance, with a modest CT increment in the fully nested comparison and a larger apparent increment in the restricted available-variable comparator. The CT contribution remains exploratory and comparator-dependent. External validation, full selection-aware validation, quantitative CT repeatability assessment, and prospective impact evaluation are required before clinical use.
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BibTeX
@article{xie2026multimodal,
title = {{Multimodal prediction of documented 1-year asthma exacerbation risk incorporating a static baseline CT digital-twin framework: a retrospective cohort study}},
author = {Mei Xie and Xiaofei Jin and Shaojin Wang and Hanchi Yu and Jindong Cheng and Shuni Wang and Yating Zhang and Xiaotong Guo and Jinxia Li and Hui Li and Hongyi Wang and Hongyi Wang and Xiaoyan Yang},
journal = {Frontiers in Digital Health},
year = {2026},
month = oct,
doi = {10.3389/fdgth.2026.1935315},
url = {https://doi.org/10.3389/fdgth.2026.1935315},
note = {CC BY},
}
RIS
TY - JOUR
TI - Multimodal prediction of documented 1-year asthma exacerbation risk incorporating a static baseline CT digital-twin framework: a retrospective cohort study
AU - Mei Xie
AU - Xiaofei Jin
AU - Shaojin Wang
AU - Hanchi Yu
AU - Jindong Cheng
AU - Shuni Wang
AU - Yating Zhang
AU - Xiaotong Guo
AU - Jinxia Li
AU - Hui Li
AU - Hongyi Wang
AU - Hongyi Wang
AU - Xiaoyan Yang
PY - 2026
DA - 2026/10/26
JO - Frontiers in Digital Health
DO - 10.3389/fdgth.2026.1935315
UR - https://doi.org/10.3389/fdgth.2026.1935315
AB - BackgroundTo develop and conditionally evaluate a multimodal prediction model incorporating a static baseline CT digital-twin framework for documented 1-year asthma exacerbation risk.MethodsThis retrospective single-center study analyzed 505 adults with asthma. Baseline three-dimensional CT reconstruction supplied quantitative features; the static baseline CT digital-twin framework did not simulate physiology or update dynamically. A LASSO-selected 10-variable logistic score was evaluated using nested domain comparisons, calibration, Brier score, and 1,000 bootstrap refits conditional on the selected predictor set. An available-variable clinical comparator was evaluated with and without CT features.ResultsSeventy-two patients (14.3%) had a documented exacerbation. The final score had apparent AUC 0.880 (conditional bootstrap 95% CI, 0.836–0.917) and Brier score 0.086. Fixed-predictor bootstrap correction yielded AUC 0.856, calibration slope 0.875, intercept −0.182, and Brier score 0.094, without accounting for the original variable-selection step. CT increased AUC from 0.880 to 0.894 in the fully nested comparison (likelihood-ratio P = 0.070), and from 0.725 to 0.774 in the available-variable comparator (P < 0.001). These were apparent, exploratory comparisons, not external validation.ConclusionThe multimodal score showed conditional internal performance, with a modest CT increment in the fully nested comparison and a larger apparent increment in the restricted available-variable comparator. The CT contribution remains exploratory and comparator-dependent. External validation, full selection-aware validation, quantitative CT repeatability assessment, and prospective impact evaluation are required before clinical use.
SN - 2673-253X
ER -