[Prediction modeling for fall alertness impairment in Meniere's disease: development and clinical validation].

Objective

To analyze the factors influencing the low fall awareness in patients with Meniere's disease, construct a prediction model, and validate it, providing a reference for clinical medical staff to identify patients with Meniere's disease who have low fall awareness.

Methods

A total of 341 patients diagnosed with Meniere's disease who received treatment in our hospital's Department of Otolaryngology, Head and Neck Surgery from June 2020 to June 2024 were selected for the study and randomly assigned into two groups: a training set consisting of 238 individuals and a validation set comprising 103 individuals, following a 7︰3 ratio. Patients were assessed using a general information questionnaire, the Social Frailty Screening Tool, the Tilburg Frailty Indicator, and the Fall Awareness Scale. Multivariate logistic regression analysis was employed to identify the factors influencing low fall awareness patients with Meniere's disease. RStudio was used to construct a nomogram for predicting low fall awareness in these patients. The model's discrimination, calibration, and clinical net benefit were validated using receiver operating characteristic（ROC） curves, calibration plots, and Decision Curve Analysis（DCA）.

Results

The results of the multivariate logistic regression analysis indicated that age, history of falls in the past year, severity of vertigo symptoms, social frailty score, and Tilburg Frailty Indicator score were independent risk factors for low fall awareness patients with Meniere's disease. The Hosmer-Lemeshow χ² test showed χ²=8.863, P=0.354, indicating good calibration of the predictive model. The area under the ROC curve for the training and validation sets was 0.868 and 0.878, respectively, demonstrating good discrimination of the model. The DCA decision curve indicated that the clinical utility of the model was satisfactory.

Conclusion

The constructed nomogram performed well and can assist clinical medical staff in quickly and effectively screening patients with Meniere's disease who are at risk of low fall awareness.