对双重医疗保健系统用户和阿片类药物使用障碍风险的深度学习分析
Ying Yin1,2, Elizabeth Workman1,2, Phillip Ma1,2
1Washington DC VA Medical Center, Washington, DC, USA.
Scientific reports
|January 29, 2025
概括
双系统使用增加了退伍军人的阿片类药物使用障碍 (OUD) 风险. 高龄和先前的药物使用改变了这种风险,突出了需要注意的特定患者群体.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 人工智能在医学中的应用
- 退伍军人健康 退伍军人的健康
背景情况:
- 阿片类药物危机对美国退伍军人产生了重大影响.
- 接受VA和非VA系统 (双系统用户) 护理的退伍军人面临更高的阿片类药物使用障碍 (OUD) 风险.
- 关于双系统使用如何与患者因素相互作用以影响OUD的研究有限.
研究的目的:
- 调查使用双系统对退伍军人OUD风险的影响.
- 探索OUD开发中的双系统使用,人口因素和临床因素之间的相互作用.
- 利用先进的人工智能来分析大型退伍军人健康数据集.
主要方法:
- 对来自VA医疗中心的856,299例患者 (2012-2019) 的回顾性研究.
- 利用深度神经网络 (DNN) 和可解释的AI来分析双系统使用和OUD.
- 使用自然语言处理的临床笔记和ICD-9/10诊断识别了OUD.
主要成果:
- 双系统使用被证实是OUD (AUC 78%) 的重要风险因素.
- 以前的阿片类药物或其他物质使用也增加了OUD风险.
- 高龄与较低的OUD风险相关,但与双系统使用有积极的相互作用;其他药物使用史有负面的相互作用.
结论:
- 双系统使用是退伍军人OUD的关键风险因素.
- 特定的人口和临床因素,如年龄和其他药物使用,改变双系统用户的OUD风险.
- 在双重系统用户群中,具有确定的风险概况的退伍军人需要有针对性的干预措施.
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