Evidence mapPaperPMID 41939770Full record

ArticleFrontiers in medicine2026

Nomogram for medication nonadherence risk prediction in post-valve surgery patients: a retrospective study.

Wenjuan Ye, Hanxiang Ma, Ke Yang, Yan Xu, Xiaoyan Wang, Cuicui Peng, Lancai Guo

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Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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7 authors.

Wenjuan YeDepartment of Cardiovascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Hanxiang MaDepartment of Cardiovascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Ke YangDepartment of Cardiovascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Yan XuDepartment of Cardiovascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Xiaoyan WangDepartment of Cardiovascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Cuicui PengDepartment of Cardiovascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Lancai GuoDepartment of Cardiovascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: To develop and internally validate a nomogram for individualized prediction of post-valvular surgery medication nonadherence risk. Materials and methods: We developed a prediction model in 244 post-valvular surgery patients enrolled between March 2025 and July 2025. Medication adherence was assessed using the Adherence to Refills and Medications Scale (ARMS). Among the 244 included patients, 112 were classified as nonadherent (ARMS score >16). Predictor selection was performed using least absolute shrinkage and selection operator (LASSO) regression, followed by multivariable logistic regression for nomogram construction. With 112 outcome events and five predictors in the final model, the events-per-variable ratio was 22.4, supporting sample size adequacy for exploratory prediction model development. Model performance was evaluated by the concordance index (C-index), area under the receiver operating characteristic curve (AUC), calibration, and decision curve analysis (DCA). Internal validation was performed using 1,000 bootstrap resamples in accordance with TRIPOD-oriented reporting principles. Results: The final nomogram incorporated five key predictors: use of warfarin, children accompany, dosing frequency daily, education level, and distance to hospital. The model demonstrated excellent discrimination, with a C-index of 0.839 (95% CI: 0.808-0.870) in the training cohort, and maintained strong predictive performance during internal validation (C-index = 0.833). Calibration plots indicated good agreement between predicted and observed probabilities. Decision curve analysis showed that the nonadherence nomogram was clinically useful when the threshold was between 12 and 68%. The AUC was found to be 0.817 [95% CI = 0.784-0.845] in the training set. Conclusion: This validated nomogram incorporating warfarin use, children accompany, dosing frequency daily, education level, and distance to hospital provides a practical tool for individualized prediction of medication nonadherence risk in post-valvular surgery patients.

Indexed as

medication adherence scalemedication noadherencenomogrampost-valvular surgeryprediction model

Identifiers

PMID41939770
PMCPMC13043363

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.