脊柱手术中的预测分析:冒险行为如何影响手术决策
Aiyush Bansal1, Philip Louie, Murad Alostaz
1From the Virginia Mason Medical Center, Seattle, WA (Bansal, Louie, Kumar, Nemani, and Leveque), the Rosalind-Franklin University, Chicago, IL (Alostaz), and the University of Washington, Seattle, WA (Yip, Joko, Michael, and Qiao).
概括
患者的个性和风险耐受性会影响脊柱手术的选择. 较低的感知风险和更高的潜在回报,以及较年轻的年龄和特定的性格特征,预测了手术决策.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 医疗决策的制定 医疗决策的制定
- 心理社会因素 心理社会因素
背景情况:
- 了解患者的风险承担和对并发症的耐受性对于定制脊柱手术建议至关重要.
- 心理社会因素,与临床指标一起,可以为脊柱病理的手术决策提供信息.
研究的目的:
- 开发一个预测模型,整合临床和心理社会因素,用于脊柱手术决策.
- 调查是否更高的冒险倾向与选择高风险,高回报的脊柱手术相关.
主要方法:
- 一项对797名参与者进行的横截面研究,使用假设的脊髓手术场景.
- 参与者完成了关于人口统计,残疾 (奥斯威斯特残疾指数) 和承担风险 (特定领域承担风险调查) 的调查.
- 一个XGBoost模型根据感知风险,改善概率和心理社会因素预测了手术可能性.
主要成果:
- 预测模型实现了0.75.5的R平方.
- 较低的并发症风险,更高的改善概率,年轻的年龄和更高的BMI预测了手术的可能性.
- 在金融和娱乐风险领域的较低分数与选择手术有关.
结论:
- 将心理社会层面纳入预测模型可以个性化手术风险讨论.
- 将治疗建议与患者的价值观和风险感知相协调,可以提高脊椎外科手术中以患者为中心的护理.
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