开发和验证心理健康和物质使用障碍预后指数的发展和验证
Talya Peltzman1, Jenna Park2, Brian Shiner3
1Veterans Affairs Medical Center, White River Junction, VT, USA.
General hospital psychiatry
|November 21, 2023
概括
一个新的指数,I-6,有效量化了退伍军人事务患者的心理健康,物质使用和障碍 (MHSUD) 负担. 该工具有助于调整MHSUD相关住院和死亡的风险.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 精神病学是一个精神病学.
- 数据科学数据科学数据科学
背景情况:
- 心理健康和物质使用障碍 (MHSUD) 在患者群体中构成重大负担.
- 准确量化MHSUD负担对于有效的患者管理和风险分层至关重要.
- 现有的方法可能无法充分捕捉MHSUD的多面性质.
研究的目的:
- 开发一种可访问和有效的指数,用于量化退伍军人事务 (VA) 医院患者中MHSUD负担.
- 确定可预测MHSUD相关结果的关键诊断类别.
- 在临床和研究环境中创建一个风险调整工具.
主要方法:
- 利用了21个诊断和统计手册 (DSM) 疾病类别,来自初级保健 (PC) 接触和前一年.
- 产生了独特疾病类别的患者级计数.
- 雇员对培训样本进行了多项逻辑回归,以确定MHSUD住院和死亡的预测DSM类别.
- 通过校准和歧视措施在全人口中验证和完善指数.
主要成果:
- 开发的指数 (I-6) 包含六个关键疾病类别:物质使用,抑郁,精神病,双极,创伤和人格.
- 在整个VA人群中,I-6显示了MHSUD死亡 (C=0.66) 和住院 (C=0.88) 的强有力的预测歧视.
- 该指数是精心校准的,在按疾病严重程度加权时,观察到的结果和预测的结果之间有很好的一致性.
结论:
- I-6是量化MHSUD负担的节和有效工具.
- 该指数可用于退伍军人事务卫生保健机构的风险调整.
- 这些发现支持使用I-6来改善MHSUD患者管理和预测结果.
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