ORIGINAL RESEARCH article
Front. Med.
Sec. Pulmonary Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1640399
Development and validation of a clinical prediction model for Aspergillus 1 fumigatus sensitization in adults with asthma: A retrospective study
Provisionally accepted
- The First hospital of Qinhuangdao, He bei, China
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Background: Aspergillus fumigatus sensitized asthma (AFSA) is associated with severe exacerbations 13 and progressive lung damage; however, diagnosis remains challenging in resource-limited settings 14 owing to limited access to Aspergillus-specific IgE (A. f-sIgE) testing. We aimed to develop a clinical 15 prediction model using routinely available biomarkers for AFSA identification. 16 17 Methods: This retrospective study enrolled 92 adult patients with asthma at The First Hospital of 18 Qinhuangdao between 2023 and 2025.. Participants were classified into AFSA and non-AFSA groups. 19 Candidate predictors (demographics and hematological parameters) were analyzed using Least 20 Absolute Shrinkage and Selection Operator (LASSO) regression, with subsequent multivariable 21 logistic regression. Performance was validated via receiver operating characteristic (ROC) curves, 22 calibration plots, and decision curve analysis (DCA). 23 24 Results: Among 92 patients (mean age 56.5 ± 12.8 years; 60.9% female), 44.6% (n=41) had AFSA. 25 LASSO selected five predictors: sex, monocyte percentage, monocyte absolute count, lymphocyte 26 percentage, and total IgE (TIgE). Final model retained male sex (Odds Ratio [OR] = 10.688; 95% 27 Confidence Interval [CI]: 1.661–152.999) and TIgE (OR= 1.006; 95% CI: 1.003–1.011). The model 28 achieved excellent discrimination: training cohort (Area Under the Curve [AUC] = 0.96, sensitivity = 29 0.93, specificity = 0.92); validation cohort (AUC = 0.88, sensitivity = 0.75, specificity = 1.00). Sex-30 specific TIgE cutoffs (527.5 IU/mL [males], 906.1 IU/mL [females]) yielded 79.2% accuracy. 31 32 Conclusions: The developed prediction model using gender and TIgE provides a practical, accessible 33 tool for AFSA screening, overcoming diagnostic barriers in settings lacking A. f-sIgE testing. However, 34 this model remains exploratory and requires multicenter external validation before widespread clinical 35 implementation.
Keywords: Aspergillus fumigatus, sensitization, Asthma, Prediction model, Total IgE
Received: 03 Jun 2025; Accepted: 08 Sep 2025.
Copyright: © 2025 Liu, Tian, Yu, Niu and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Shufeng Xu, The First hospital of Qinhuangdao, He bei, China
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