在承认成人发病多发性硬化症之前,医疗保健利用的信息模式:基于人口的研究
Fardowsa L A Yusuf1, Mohammad Ehsanul Karim2, Jason M Sutherland3
1School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada; Medicine (Neurology), University of British Columbia and The Djavad Mowafaghian Centre for Brain Health, Vancouver, BC, Canada.
Multiple sclerosis and related disorders
|June 12, 2025
概括
在多发性硬化症 (MS) 诊断之前了解医疗保健的使用,揭示了不同的患者轨迹. 频繁获得医疗保健可能表明风险更高,并可能允许更早的干预,以减轻MS中残疾进展.
科学领域:
- 神经学 神经学
- 医疗保健服务研究 医疗服务研究
- 流行病学 流行病学
背景情况:
- 早期识别多发性硬化症 (MS) 是一个挑战.
- 了解诊断前的医疗保健使用情况对于识别有风险的个体至关重要.
- 在MS前识别医疗保健轨迹和随后的残疾之间的关系尚未得到充分理解.
研究的目的:
- 描述在成人开始MS认可之前的十年中医疗保健使用的联合轨迹.
- 检查与这些轨迹相关的人口和临床特征.
- 评估前MS认可医疗保健轨迹与随后的残疾之间的关联.
主要方法:
- 利用了加拿大不列颠哥伦比亚省 (1991-2020) 的相关行政和临床数据.
- 在MS指数日期之前使用基于群体的多轨迹模型来识别医疗保健使用模式 (医生访问,住院,处方).
- 在不同轨迹中比较人口统计和预指数遭遇;分析了与临床队列中的轨迹相关的残疾分数.
主要成果:
- 确定了三个不同的医疗保健使用轨迹 (低,中等,高) 在行政和临床MS认可日期之前.
- 中度和高度轨迹的个体更有可能是女性,年长,并且早些时候就医和神经系统诊断.
- 适度的医疗保健使用轨迹与随后的残疾增加有关 (调整后β=0.31,95% CI:0.09-0.53).
结论:
- 在MS诊断之前经常获得医疗保健可能表明风险更高,并使全科医生能够更早地检测到.
- 对于已确定轨迹的患者,迅速启动疾病修饰疗法可能会减轻残疾进展.
- 对医疗保健利用模式中的预测标志物进行进一步的研究是有必要的,以改善MS管理.
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