开发和验证一个预测评分模型,用于结核病风险分层,治疗中断和结核病风险分层
Ai Ling Oh1, Mohd Makmor-Bakry2, Farida Islahudin3
1Centre of Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; Department of Pharmacy, Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Sarawak, Malaysia.
Research in social & administrative pharmacy : RSAP
|September 1, 2024
概括
预测结核病治疗中断是预防耐药性的关键. 一个新的评分模型识别了高风险患者,使得有针对性的干预措施能够改善结果并减少传播.
科学领域:
- 公共卫生 公共卫生
- 传染病流行病学 传染病流行病学
- 临床研究 临床研究
背景情况:
- 结核病 (TB) 治疗中断会增加抗菌素耐药性,治疗失败和死亡率.
- 早期干预对于改善结核病治疗结果和制传播至关重要.
研究的目的:
- 确定结核病治疗中断的风险因素.
- 开发一个预测得分模型,用于对结核病治疗中断的客观风险分层.
主要方法:
- 马来西亚萨拉瓦克的多中心回顾性队列研究 (2022年3月 - 2023年1月).
- 包括在2018-2021年期间诊断出耐药结核病的成年患者 (≥18岁).
- 使用多重逻辑回归分析18个变量;使用分割样本方法开发和验证模型.
主要成果:
- 模型在验证数据上显示出良好的校准 (P=0.143) 和辨别能力 (AUC=0.775).
- 确定了危险因素:吸烟,先前接受过结核病治疗,药物不良反应;糖尿病具有保护作用.
- 风险分层 (低,中,高) 显示中断率增加 (5.3%,18.1%,41.3%).
结论:
- 一个经过验证的预测评分模型有效评估结核病治疗中断风险.
- 该模型为高风险患者提供了有针对性的监测和个性化干预措施.
- 早期识别有风险的个体可以改善结核病治疗的坚持和结果.
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