多囊性卵巢综合征低诊断模式 个人层面和空间层面的社会脆弱性措施
Emily L Silva1, Kevin J Lane2, Jay Jojo Cheng3
1Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
The Journal of clinical endocrinology and metabolism
|October 12, 2024
概括
种族和社会经济因素有助于遗漏的多囊卵巢综合征 (PCOS) 诊断. 解决这些差异对于早期干预和改善PCOS识别患者结果至关重要.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 医疗保健服务研究 医疗服务研究
- 医疗信息学 医疗信息学
背景情况:
- 多囊卵巢综合征 (PCOS) 是一种常见的内分泌疾病,具有重大诊断挑战.
- 及时诊断PCOS对于管理相关健康风险和改善患者生活质量至关重要.
研究的目的:
- 使用电子健康记录 (EHR) 识别符合PCOS标准的患者遗漏诊断的个人层面和空间预测因素.
- 分析多样化的患者群体中PCOS诊断率的差异.
主要方法:
- 利用波士顿医疗中心2003年至2015年的EHR数据,评估PCOS相关症状或情况的患者.
- 采用后勤回归模型来评估人口,社会经济和社会脆弱因素与错过的PCOS诊断的关联.
- 使用ICD代码和在盆腔超声报告上的自然语言处理来定义PCOS病例.
主要成果:
- 鉴定了PCOS诊断的差异,与非西班牙裔白人患者相比,黑人/非洲裔美国患者的错误诊断几率更高 (OR=1.69).
- 与私人保险患者相比,依赖医疗补助或慈善保险的患者错过PCOS诊断的几率增加了 (OR=1.90).
- 在单变量分析中,较高的社会脆弱性指数 (SVI) 分数与错误诊断的几率增加有关.
结论:
- 在诊断PCOS时观察到显著的个人层面和空间差异.
- 强调需要进一步研究这些差异的驱动因素,以便更早,更公平地进行PCOS诊断和干预.
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