Risk Management and Healthcare Policy最新文献

{"title":"Prevalence and Correlates of Mental Health Problems in Resident Physicians in Inner Mongolia Autonomous Region: A Cross-Sectional Study.","authors":"Yan Zhang, Li Zhang, Jianyu Que, Miao Jia, Xi Nan, Juanniu Zhang, Haifei Gao, Lixia Chen","doi":"10.2147/RMHP.S494326","DOIUrl":"https://doi.org/10.2147/RMHP.S494326","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates the prevalence and contributory factors of mental health issues, including anxiety, depression, and insomnia, among resident physicians. Additionally, it endeavors to understand the complex characteristics of these issues across different demographic groups.</p><p><strong>Methods: </strong>Using an online cross-sectional design, the study engaged resident physicians in Inner Mongolia, China, through convenience sampling. Questionnaires collected data on sociodemographic background, training details, and symptoms of depression, anxiety, and insomnia, assessed using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Insomnia Severity Index (ISI). Conduct latent class analysis on psychological issues using Mplus software. Analyze the related influencing factors of different group characteristics using a multivariate logistic regression model.</p><p><strong>Results: </strong>The study comprised 2891 resident physicians, revealing that 20.3% experienced moderate to severe anxiety, 19.72% had moderate to severe depression, and 9.6% faced moderate to severe insomnia. Latent class analysis identified three distinct mental health groups: a high anxiety-depression-insomnia group, a low anxiety-depression-healthy sleep group, and a moderate anxiety-mild depression-variable insomnia group. Factors such as training stage, professional accomplishments, self-reported medical errors, self-esteem, perceived stress, and social support were significantly associated with mental health issues, as identified by multivariate logistic regression.</p><p><strong>Conclusion: </strong>The mental health problems among residents are prominent. By analyzing mental health status and influencing factors, residents can be categorized into different groups, allowing for more targeted interventions. These interventions may include stress management, communication skills training, crisis intervention, and the development of support systems, along with improvements to the work environment and a focus on humanistic care.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1377-1385"},"PeriodicalIF":2.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Correlation Between Patient Safety Culture and Adverse Medical Events Using Failure Mode and Effect Analysis (FMEA).","authors":"Yang Cui, Yu Wang, He Liu, Shaojie Xu, Xue Zhang","doi":"10.2147/RMHP.S502725","DOIUrl":"https://doi.org/10.2147/RMHP.S502725","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the correlation between medical safety adverse events and patient safety culture through the lens of Failure Mode and Effect Analysis (FMEA).</p><p><strong>Methods: </strong>Sixty patients from a hospital were selected as the research subjects, alongside 440 medical staff members (including clinical, medical technology, and management personnel) who participated in the study. The general demographic characteristics of medical staff, patient safety culture, and adverse medical safety events were investigated. FMEA was employed to analyze the relationship between medical safety adverse events and patient safety culture, using the risk priority number (RPN) as a key metric.</p><p><strong>Results: </strong>A comparison of RPN values before and after FMEA intervention revealed that the RPN values of each failure mode significantly decreased post-intervention. Correlation analysis showed significant relationships between medication errors and several factors: \"incident reporting frequency\" (OR=0.706), \"manager expectations and actions to promote patient safety\" (OR=0.733), and \"management support for patient safety\" (OR=0.755). Pressure ulcers were significantly correlated with \"manager expectations and actions to promote patient safety\" (OR=0.729) and \"shift and transfer\" (OR=0.707). Falls were notably associated with \"interdepartmental cooperation\" (OR=0.735), \"feedback and communication about errors\" (OR=0.756), and \"shift and transfer\" (OR=0.660). Additionally, a strong correlation was identified between adverse events and \"management support for patient safety\" (OR=0.701).</p><p><strong>Conclusion: </strong>Utilizing FMEA to analyze the correlation between medical safety adverse events and patient safety culture is effective in identifying specific dimensions of these events related to safety culture. This enables the development of targeted interventions to mitigate adverse events and enhance patient safety.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1367-1376"},"PeriodicalIF":2.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Feasibility and Effectiveness of an Interdisciplinary Verbal De-Escalation and Implicit Bias Check Training for Agitation Management in the Emergency Department.","authors":"Jossie A Carreras Tartak, Giovanni Rodriguez, Madeline Schwid, Melissa A Meeker, Matthew D Thomas, Harold J Roy, Farah Z Dadabhoy, Melanie Molina, Anita Chary, Alice K Bukhman, Dana D Im, Elizabeth S Temin, Wendy L Macias-Konstantopoulos","doi":"10.2147/RMHP.S513026","DOIUrl":"https://doi.org/10.2147/RMHP.S513026","url":null,"abstract":"<p><strong>Purpose: </strong>Recent scholarship has revealed racial disparities in emergency department (ED) physical restraint use in agitation management. We implemented an interdisciplinary educational program that integrates discussions about the role of bias in physical restraint use with workplace violence (WPV) prevention strategies to increase awareness of implicit bias and comfort with verbal de-escalation among ED staff.</p><p><strong>Patients and methods: </strong>In partnership with hospital security at a large urban academic medical center, we developed a 1-hour online WPV prerequisite course followed by a 2-hour multi-modal, in-person training consisting of 40 minutes each of didactics, an interactive defensive skills workshop, and case-based simulations with structured debriefings. From September 2022 to June 2023, all patient-facing ED staff were invited to participate and received a $100 gift card for program completion. Participants rated their confidence and comfort in various aspects of agitation management on a 5-point Likert scale before and immediately after via pre- and post-training surveys. Wilcoxon matched-pairs tests were employed for analysis.</p><p><strong>Results: </strong>Of 91 participants, 72 (79%) completed the pre- and post-training surveys. Representing a wide range of ED role groups, 74% of participants were clinical staff and a majority had 0-5 years of experience (65%). Among all participants, there was a statistically significant improvement in confidence and comfort with the various aspects of agitation management across all 11 questions (p<0.001). A similar change was observed among the clinical staff (p<0.001), however, the degree of improvement observed among those with greater than 5 years of experience was less dramatic than among clinical staff with 0-5 years of experience.</p><p><strong>Conclusion: </strong>Interdisciplinary multi-modal training can improve confidence and comfort with verbal de-escalation and implicit bias checks in team-based agitation management. Additional research is needed to understand if such integrated training can also reduce physical restraint use, racial disparities in restraint use, and WPV events.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1355-1366"},"PeriodicalIF":2.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Symptom Cluster in NSCLC Patients and Its Relationship with Social Support and Self-Efficacy: A Cross-Sectional Study.","authors":"Juan Cao, Keyu Chen, Lihong Gao, Dandan Yang, Wenjuan Zhang, Xiaheng Deng, Changpeng Liu, Qi Dai, Xinyi Xu, Fang Li","doi":"10.2147/RMHP.S518188","DOIUrl":"https://doi.org/10.2147/RMHP.S518188","url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to identify symptom clusters among NSCLC patients within 3 months postoperatively and analyze the relationships between symptom clusters and social support and self-efficacy.</p><p><strong>Methods: </strong>We conducted a cross-sectional study from January 1 to May 31, 2024, involving NSCLC patients undergoing surgery at hospitals in Jiangsu Province. Data were collected using the MD Anderson Symptom Inventory, the Perceived Social Support Scale (PSSS), and the Strategies Used by People to Promote Health (SUPPH).</p><p><strong>Results: </strong>Exploratory factor analysis revealed five distinct symptom clusters: respiratory distress, respiratory tract discomfort, physical exhaustion, digestive dysfunction, and nighttime disturbances. The severity of physical exhaustion and nighttime disturbances was negatively correlated with PSSS scores. Conversely, the severity of respiratory distress, respiratory tract discomfort, and digestive dysfunction symptoms was negatively correlated with SUPPH scores.</p><p><strong>Conclusion: </strong>Our findings may guide medical professionals in managing postoperative symptoms in NSCLC patients. Social support and self-efficacy appear to be significant factors influencing the severity of symptom clusters.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1347-1354"},"PeriodicalIF":2.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Autonomy Reform on the Efficiency of Public Hospitals in China: A DEA-ITSA Combination Analysis.","authors":"Ningbo An, Quan Zou, Ji-Bin Li, Kaiyuan Luo, Gang Sun, Xing Ni, Oudong Xia","doi":"10.2147/RMHP.S514512","DOIUrl":"https://doi.org/10.2147/RMHP.S514512","url":null,"abstract":"<p><strong>Purpose: </strong>Since 2014, China has been rolling out a new autonomy reform for public hospitals, aiming to enhance their efficiency and better utilize the health budgets. The purpose of this research is to assess the reform's success and explore its effects on hospital outcome efficiency, laying a foundation based on empirical evidence for future policy decisions.</p><p><strong>Methods: </strong>The data envelopment analysis(DEA) and interrupted time-series analysis (ITSA) approaches were combined to analyze the reform impacts on the 16 samples of Shenzhen municipal public hospitals in China, using data extracted from the Shenzhen Health Statistics Yearbook from 2002 to 2023.</p><p><strong>Results: </strong>The results revealed that from 2002 to 2023, 15 out of 16 sample hospitals achieved total factor productivity improvement in Shenzhen city of China, with the average growth rate of Malmquist total factor productivity index(MI) was 3.05% and the highest growth rate was 6.93%, yet only one hospital showing a growth rate of -0.02%. The results of ITSA show a significant intervention in 2014. After the policy intervention, the fixed reference Malmquist total factor productivity index(FRMI) for the general and the specialty hospital group increased at rates of 0.04680(P<0.000) and 0.1746(p<0.000) per year by the Newey-West model, similarly, the rates of 0.04689(P<0.000) and 0.1762(p<0.000) per year by the Prais-Winsten model.</p><p><strong>Conclusion: </strong>The reform has positively impacted public hospitals' total factor productivity(TFP). The TFP of the general hospitals was increasing before the policy intervention of autonomy hospitals, but the time of its implementation was associated with a more significant rise. Meanwhile, the TFP of specialty hospitals decreased before the intervention; however, its trend shifted to growth after the intervention. This research further emphasizes the applicability of the DEA-ITSA combination method as an effective tool for health policies evaluation using public data within China's healthcare framework.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1333-1346"},"PeriodicalIF":2.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness Analysis of Serplulimab Combined with Nab-Paclitaxel Plus Carboplatin Compared to Nab-Paclitaxel Plus Carboplatin Alone as First-Line Treatment for Advanced Squamous Non-Small Cell Lung Cancer in China.","authors":"Hongting Yao, Kai Xu, Man Yu, Xiaoye Wang, Yingzhi Lu, Xin Li, Hong Wu","doi":"10.2147/RMHP.S506976","DOIUrl":"https://doi.org/10.2147/RMHP.S506976","url":null,"abstract":"<p><strong>Purpose: </strong>The ASTRUM-004 trial demonstrated the efficacy of serplulimab combined with nab-paclitaxel plus carboplatin chemotherapy in untreated patients with advanced squamous non-small cell lung cancer (NSCLC). Our study aimed to evaluate the cost-effectiveness of this combination therapy compared to that of nab-paclitaxel plus carboplatin chemotherapy alone for advanced squamous NSCLC patients from the perspective of the Chinese healthcare system.</p><p><strong>Patients and methods: </strong>A partitioned survival model based on the survival data of the ASTRUM-004 trial was constructed to assess the cost-effectiveness. The direct medical costs and utilities were derived from published literature and real-world medical institutions. The total costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) were calculated. Sensitivity analyses and scenario analyses were conducted to assess the robustness of the model.</p><p><strong>Results: </strong>The base-case analysis revealed that serplulimab combined with nab-paclitaxel plus carboplatin chemotherapy provided 0.53 incremental QALYs at an incremental cost of $60,790.77, with an ICER of $114,207.24/QALY. The ICER significantly exceeded the Chinese willingness-to-pay threshold ($37,743.79/QALY). Body weight, the utility value of progression-free survival stage, and the price of serplulimab were the main influencing factors of the ICER. Probabilistic sensitivity analysis revealed that there was no possibility of cost-effectiveness under the current threshold. Scenario analyses revealed that this combination therapy would only be cost-effective if the price of serplulimab fell by at least 80.3%.</p><p><strong>Conclusion: </strong>Compared to nab-paclitaxel plus carboplatin chemotherapy alone, serplulimab combined with nab-paclitaxel plus carboplatin chemotherapy might not be economical for advanced squamous NSCLC patients in China under current pricing conditions. This study suggests that future price reductions for serplulimab could make this therapy more economically viable and provide guidance for drug pricing decisions.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1309-1321"},"PeriodicalIF":2.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research on Dynamic Outpatient Respiratory Nosocomial Infection Control Methods Through Multi-Data Prediction.","authors":"Yuncong Wang, Wenhui Ma, Yang Yang, Huijie Zhao, Zhongjing Zhao, Xia Zhao","doi":"10.2147/RMHP.S508760","DOIUrl":"https://doi.org/10.2147/RMHP.S508760","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop a dynamic prevention and control method for fluctuating respiratory nosocomial infections in outpatients.</p><p><strong>Methods: </strong>Six sets of surveillance data such as influenza-like case counts and their predicted results were used in the autoregressive integrated moving average model (ARIMA) to forecast the onset and end time points of the epidemic peak. A Delphi process was then used to build consensus on hierarchical infection control measures for epidemic peaks and plateaus. The data, predicted results, and hierarchical infection control measures can assist dynamic prevention and control of respiratory nosocomial infections with changes in the infection risk.</p><p><strong>Results: </strong>The ARIMA model produced exact estimates. The mean absolute percentage errors (MAPE) of the data selected to estimate the time range of the high-risk and low-risk periods were 15.8%, 9.2%, 15.4%, 16.8%, 25.6%. The hierarchical infection control measures included three categories and nine key points. A risk-period judgment matrix was also designed to connect the surveillance data and the hierarchical infection control measures.</p><p><strong>Conclusion: </strong>Through a mathematical model, dynamic prevention and control of respiratory tract infections in outpatients was constructed based on the daily medical service monitoring data of hospitals. It is foreseeable that when applied in medical institutions, this method will provide accurate and low-cost infection prevention and control outcomes.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1323-1332"},"PeriodicalIF":2.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Burden of Alzheimer's Disease Attributable to High Fasting Plasma Glucose: Epidemiological Trends and Machine Learning Insights.","authors":"Yixiao Ma, Shuohan Huang, Yahong Dong, Qiguan Jin","doi":"10.2147/RMHP.S506581","DOIUrl":"https://doi.org/10.2147/RMHP.S506581","url":null,"abstract":"<p><strong>Purpose: </strong>High fasting plasma glucose (HFPG) is a known risk factor for Alzheimer's disease (AD). This study aims to analyze global trends in AD death rates and disability-adjusted life years (DALYs) rates attributable to HFPG from 1990 to 2021 and assess the potential of glucose-related biomarkers in predicting cognitive impairment.</p><p><strong>Methods: </strong>Data from the Global Burden of Disease 2021 database were used to analyze AD death rates and DALY rates due to HFPG across 204 countries. All rates were age-standardized. Joinpoint regression, age-period-cohort models, and ARIMA were employed to analyze trends and make future predictions. NHANES data were used to build machine learning models (including logistic regression, SVM, random forests, etc). to evaluate glucose-related biomarkers in predicting cognitive impairment.</p><p><strong>Results: </strong>From 1990 to 2019, global AD death rates attributable to HFPG increased from 2.64 (95% UI: 0.11, 8.38) to 3.73 (95% UI: 0.15, 11.84), with the highest increases in high-income North America, North Africa, and Sub-Saharan Africa. DALY rates also rose globally, from 47.07 (95% UI: 2.72, 126.46) to 66.42 (95% UI: 3.83, 178.85). The greatest impact was observed in females, particularly those aged 80 and above. Joinpoint analysis indicated a significant rise in death rates from 1995 to 2000, followed by a slower increase in recent years. ARIMA model predictions indicate a gradual decline in death rates and DALY rates over the next 15 years. Logistic regression models showed the highest accuracy (90.4%) in predicting cognitive impairment, with 2-hour postprandial glucose and fasting plasma glucose being key predictors.</p><p><strong>Conclusion: </strong>From 1990 to 2021, global AD death rates and DALY rates due to HFPG significantly increased, with a greater burden in females and regions with higher socio-demographic development. Machine learning models are effective tools for identifying individuals at high risk of elevated blood glucose leading to cognitive impairment.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1291-1307"},"PeriodicalIF":2.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Nomogram Model Integrating Inflammation Markers for Predicting the Risk of Recurrent Sciatica After Selective Nerve Root Blocks.","authors":"Meng Cai, Jing Yin, Yi Jin, HongJun Liu","doi":"10.2147/RMHP.S503360","DOIUrl":"https://doi.org/10.2147/RMHP.S503360","url":null,"abstract":"<p><strong>Background: </strong>Lumbar disc herniation (LDH) usually c auses sciatica. Although selective nerve root block (SNRB) is an effective, highly target-oriented interventional procedure for patients with LDH, accurately predicting the risk of sciatica recurrence in such patients after SNRB remains a major challenge.</p><p><strong>Objective: </strong>We aimed to construct a nomogram model by integrating clinical data, imaging features and inflammation markers that could predict recurrent sciatica following SNRB in LDH patients, which fill the inflammation data gaps during model construction.</p><p><strong>Methods: </strong>In total, 121 sciatica patients were enrolled and assigned to the recurrence group (n = 41) and non-recurrence group (n = 80). By performing the logistic regression analyses, we identified risk factors serving as independent predictors and constructed the nomogram prediction model. Then, the performance and clinical practicality of the nomogram model were validated by performing the receiver operating characteristic curve (ROC) analysis, calibration curve analysis, and decision curve analysis (DCA). The bootstrap method was applied for the internal validation of the nomogram model.</p><p><strong>Results: </strong>Preoperative sensory symptoms (odds ratio [OR] [95% confidence interval (CI)]: 2.933 [1.211-7.353]), type of herniation (OR [95% CI]: 2.712 [1.261-6.109]), and systemic inflammation response index (OR [95% CI]: 2.447 [1.065-6.271]) were included in the nomogram for predicting unfavorable outcomes following sciatica. The nomogram AUC was 0.764, and the prognostic precision, validated using the bootstrap method, reached 0.756. The ROC and calibration curve analyses, and DCA also produced excellent results, exhibiting favorable predictive performance and clinical benefit.</p><p><strong>Conclusion: </strong>This study thus identified risk factors that predict unfavorable outcomes after sciatica and developed a risk prediction model based on clinical, radiologic, and inflammatory factors, thereby facilitating early predictions by clinicians and offering an individualized medical interventions for patients with recurrent sciatica in early stages.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1279-1289"},"PeriodicalIF":2.7,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subject Modeling-Based Analysis of the Evolution and Intervention Strategies of Major Emerging Infectious Disease Events.","authors":"Haixiang Guo, Tiantian Zhao, Yuzhe Zou, Beijia Zhang, Yuyan Cheng","doi":"10.2147/RMHP.S507704","DOIUrl":"https://doi.org/10.2147/RMHP.S507704","url":null,"abstract":"<p><strong>Objective: </strong>Due to the popularity of the Internet and the extensive use of new media, after the occurrence of infectious diseases, the spread of social media information greatly affects the group's opinion and cognition and even the health behaviors they take, thus affecting the spread of infectious diseases. Therefore, this paper studies the event evolution from multiple dimensions.</p><p><strong>Methods: </strong>To address this gap, we developed a three-layer model framework of major infectious disease event evolution based on subject modeling. This framework integrates three key factors-health transmission, perspective interaction, and risk perception-to analyze group perspective evolution, behavioral change, and virus transmission processes. The model's effectiveness was evaluated through simulation and sensitivity analysis. In addition, we conducted an empirical analysis by constructing a social media health transmission effect index system to identify the critical factors affecting health transmission.</p><p><strong>Results: </strong>Simulation results reveal that among the three factors, health transmission has the most significant impact on the evolution of group perspectives during infectious disease events. Moreover, the dynamics of public viewpoint evolution influence individual decisions regarding the adoption of non-pharmacological interventions, which are shown to effectively reduce both the transmission rate of the virus and the peak number of infections.</p><p><strong>Conclusion: </strong>The findings of this study enhance our understanding of the complex mechanisms and evolutionary pathways in infectious disease events. By integrating multiple dimensions of event evolution, the proposed model offers valuable insights for the design of effective countermeasures and strategies in emergency management and response to infectious disease outbreaks.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1257-1278"},"PeriodicalIF":2.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}