对结直肠癌患者的基于人口的数据中的脆弱性指标进行比较
Rebecca Birch1, John Taylor1, Tameera Rahman2,3
1Leeds Institute for Medical Research at St James's, University of Leeds, Leeds, UK.
Age and ageing
|May 24, 2024
概括
在患有结直肠癌的老年人中量化虚弱是具有挑战性的. 在行政数据中,三个指标 - - 医院脆弱性风险评分 (HFRS),SCARF指数和脆弱性综合征 (FS) - - 已被证明是可行的,有效的和可靠的.
科学领域:
- 老年医学 老年医学
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 结直肠癌治疗中的与年龄相关的差异已经得到了充分的证据.
- 人口老龄化的脆弱性可能会加剧这些不平等.
- 在大规模研究中,准确地评估脆弱性是很困难的.
研究的目的:
- 评估三个脆弱性指标的可行性,有效性和可靠性:医院脆弱性风险评分 (HFRS),二级护理行政记录脆弱性指数 (SCARF) 和脆弱性综合征 (FS).
- 评估这些措施在结直肠癌患者的国家队列中.
主要方法:
- 在英国国家卫生服务中对136,008名结直肠癌患者进行了回顾性分析.
- 在数据集中生成的HFRS,SCARF和FS指标.
- 与查尔森并发症指数 (CCI) 进行诊断代码比较;通过脆弱性流行率和1年生存率评估有效性.
- 使用Brier分数和c-statistic评估模型性能.
主要成果:
- 所有三个脆弱性测量 (HFRS,SCARF,FS) 都证明了可行性,有效性和可靠性.
- 在SCARF和CCI诊断码之间存在显著的重叠.
- 虚弱的患病率各不相同:SCARF在最低风险组中发现了55.4%,HFRS为85.1%,FS为81.2%.
- HFRS和FS在脆弱程度之间的1年生存率中显示出最大的差异;模型性能差异很小.
结论:
- HFRS,SCARF和FS是使用常规管理健康数据量化脆弱性的有价值工具.
- 最佳的脆弱性测量取决于流行病学研究的具体需求和背景.
- 这些经过验证的措施可以帮助理解和解决结直肠癌护理中的脆弱性.
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