在阿片类药物使用障碍中个性化6个月死亡风险的预测
Emmert Roberts1,2,3, John Strang2,4, Eve Taylor4
1National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
概括
这项研究开发了第一个预后模型,以估计阿片类药物使用障碍 (OUD) 患者的6个月死亡风险. 这些模型提供个性化的风险评估,以改善成治疗的交付.
科学领域:
- 公共卫生 公共卫生
- 成 药物 药物 药物 药物
- 生物统计学 生物统计学
背景情况:
- 患有阿片类药物使用障碍 (OUD) 的人面临的死亡率明显高于普通人群.
- 缺乏个性化的预后信息,阻碍了个性化的成治疗策略.
研究的目的:
- 开发和验证第一个预后模型,以估计OUD患者6个月所有原因和与药物相关的死亡风险.
- 使用英语成服务的基线评估指标进行风险预测.
主要方法:
- 候选预后变量 (社会人口统计学,注射状态,健康,心理健康) 由链接的国家记录 (2013-2022) 确定.
- 采用多变量考克斯回归与分数多项式和多重归算缺失的数据.
- 内部验证使用了启动,用Harrell的C和D统计来评估歧视,并通过观察到预测的速度和斜率进行校准.
主要成果:
- 这项研究分析了236,064名OUD患者的数据,记录了2427例因各种原因死亡和1289例与药物相关的死亡.
- 两种模型都显示出良好的乐观度调整的歧视和校准.
- 哈雷尔的C统计是0.73 (所有原因) 和0.74 (与药物相关);D统计分别是1.01和1.07.
结论:
- 罗伯茨开发的OUD死亡风险模型准确量化了在成服务中OUD患者个体化6个月死亡风险.
- 建议进行独立验证,以优化模型的未来政策,委托和临床决策.
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