{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T23:20:00Z","timestamp":1761952800821,"version":"build-2065373602"},"reference-count":0,"publisher":"Hematology Section, Dept. of Radiological Science and Hematology, Catholic University, Rome, Italy","issue":"1","license":[{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Mediterr J Hematol Infect Dis"],"abstract":"<jats:p>Background: Post-treatment lung destruction (LD) impairs quality of life in pulmonary tuberculosis (TB) survivors, yet early risk-stratification tools are lacking. We aimed to develop and internally validate a clinical-laboratory nomogram for predicting LD at completion of standard anti-TB therapy.\nMethods: This retrospective cohort study enrolled 205 adult, drug-na\u00efve TB patients from April 2021 to April 2025. LD was defined by follow-up chest CT showing extensive fibrosis, bronchiectasis with volume loss, or parenchymal destruction. Twenty-two baseline demographic, clinical, laboratory and imaging variables were screened. Least-absolute-shrinkage-and-selection-operator (LASSO) regression (10-fold cross-validation) reduced dimensionality, and stepwise Akaike information criterion guided multivariable logistic regression. Model performance was compared with random-forest (RF) and support-vector-machine (SVM) classifiers. Discrimination (area under the receiver-operating characteristic curve, AUC), calibration (bootstrap-corrected curve, Brier score) and clinical utility (decision-curve analysis, DCA) were assessed; 1,000-sample bootstrap provided internal validation.\nResults: LD occurred in 61\/205 patients (29.8%). Nine predictors\u2014silicosis, drug resistance, symptom-to-treatment delay, lymphocyte count, C-reactive protein, aspartate aminotransferase, \u03b3-glutamyltransferase, albumin, and atelectasis\/cavity\u2014constituted the final model. The nomogram demonstrated excellent discrimination (AUC\u202f=\u202f0.93, 95%\u202fCI\u202f0.897\u20130.971; optimism-corrected AUC\u202f=\u202f0.93) and good calibration (Brier\u202f=\u202f0.13). Across risk thresholds of 10\u201340%, DCA showed a higher net benefit than treat-all or treat-none strategies. Logistic regression was slightly better than RF (AUC\u202f=\u202f0.91) and SVM (AUC\u202f=\u202f0.92) while retaining interpretability.\nConclusions: An inexpensive, easily applicable nomogram integrating routine clinical and laboratory indices accurately predicts post-treatment LD in TB patients. The tool can support personalized follow-up and timely interventions, warranting external validation in multi-center prospective cohorts.<\/jats:p>","DOI":"10.4084\/mjhid.2025.075","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T23:16:32Z","timestamp":1761952592000},"page":"e2025075","source":"Crossref","is-referenced-by-count":0,"title":["AN INEXPENSIVE CLINICAL-LABORATORY NOMOGRAM TO PREDICT POST-TREATMENT LUNG DESTRUCTION IN PULMONARY TUBERCULOSIS"],"prefix":"10.4084","volume":"17","author":[{"given":"Min","family":"Xu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiahui","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianju","family":"Feng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2554","published-online":{"date-parts":[[2025,10,31]]},"container-title":["Mediterranean Journal of Hematology and Infectious Diseases"],"original-title":[],"link":[{"URL":"https:\/\/www.mjhid.org\/mjhid\/article\/download\/6084\/4777","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.mjhid.org\/mjhid\/article\/download\/6084\/4778","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.mjhid.org\/mjhid\/article\/download\/6084\/4777","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T23:16:32Z","timestamp":1761952592000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mjhid.org\/mjhid\/article\/view\/6084"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,31]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,1]]}},"URL":"https:\/\/doi.org\/10.4084\/mjhid.2025.075","relation":{},"ISSN":["2035-3006"],"issn-type":[{"value":"2035-3006","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,31]]}}}