危险因素:确定、评价方法、医学预后(文献综述)在自己的临床实践中使用的例子)-第一次通知

О. Fayura, А. Маksymuk, О. Аbrahamovych, М. Аbrahamovych, L. Tsyhanyk, S. Tolopko, M. Ferko
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引用次数: 1

摘要

上下文。尽管现代医学取得了最新进展,但许多疾病的直接病因仍不清楚或无法确定每种疾病在其发生中的意义,因此危险因素理论对于理论和实践医学都具有极其重要的意义。此外,经常出现需要确定患者护理最佳策略的情况,因为医生的预防,治疗和康复活动需要及时预测发生概率,病理过程的进一步发展,其并发症,由于某些环境因素引起的复发,威胁和终末期情况,药物的副作用。因此,需要切实解决这些问题成为危险因素理论和预后方法的基础。目标。确定危险因素的重要性及其计算和评估的方法,在医学预后,利用文献资料,提供具体的例子,在自己的临床实践中使用。材料和方法。运用内容分析法、系统对比分析法、文献语义学方法研究医学中危险因素重要性调查的科学研究现状及其计算、估计和预后技术。在科学计量数据库PubMed、Medline、Springer、Google Scholar、Research Gate中检索文献来源,检索关键词:危险因素、单向分析、多因素分析。我们选择并分析了54篇英文和乌克兰文的文献资料,这些文献资料强调了危险因素及其计算、评估和预后在医学中的重要性,并描述了它们在我们自己的临床实践中的应用结果。结果。风险的概念,作为不良事件或结果的概率,最常用于分析性研究,旨在确定某些情况的原因及其流行程度。风险不能通过对一个人的信息评价结果直接衡量,而是在对受某一因素影响的一组人(暴露组)进行选择性观察的基础上计算出来的。危险因素是潜在的致病因素,与之接触就可能导致疾病。要全面分析病理过程,评估危险因素和实际风险,离不开预后,也离不开多因素分析,多因素分析往往基于A. Wald的概率方法或生存曲线构建。在实际的卫生保健、医学和社会研究以及临床研究中,经常需要确定(预测)某种情况变化的趋势。结论。确定风险因素,计算实际风险和预后在医学中起着重要作用,因为在医生的实践中,日常情况需要考虑到治疗的趋势、过程、严重程度和结果,确定最佳策略。因此,它们的定义/计算必须清晰易懂。根据具体情况,医生可以使用对某些因素的评分分析,创建风险组,制定监测计划等。因此,可以制定预防措施和及时纠正治疗的计划。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Risk Factors: Method of Determination and Evaluation, Prognosis in Medicine (Literature Review; Examples of Use in Own Clinical Practice) – first notice
Context. Despite the latest advances in modern medicine, the direct etiological factors of many diseases remain unknown or it is impossible to determine the significance of each of them in their occurrence, so the theory of risk factors is extremely relevant for both theoretical and practical medicine. Besides, there often occur situations in which it is necessary to determine the optimal tactics of patient care, because preventive, curative and rehabilitation activities of the doctor require timely prediction of the occurrence probability, further course of the pathological process, its complications, recurrences due to certain environmental factors, threatening and terminal conditions, side effects of drugs. Therefore, the need for a practical solution to these problems has become the basis for the theory of risk factors and prognosis methods. Objective. To determine the significance of risk factors and methods of their calculation and evaluation, prognosis in medicine, using literature sources, provide specific examples of their use in one’s own clinical practice. Materials and methods. Content analysis, method of systemic and comparative analysis, bibliosemantic method of studying the current scientific researches concerning the investigation of the importance of risk factors and a technique of their calculation and estimation, prognosis in medicine were used. The sources were searched for in scientometric databases: PubMed, Medline, Springer, Google Scholar, Research Gate by keywords: risk factors, one-way analysis, multi-factor analysis. 54 literary sources in English and Ukrainian, which highlight the importance of risk factors and methods of their calculation and evaluation, prognosis in medicine were selected and analyzed to describe the results of their use in our own clinical practice. Results. The concept of risk, as the probability of an adverse event or outcome, is most often used in analytical studies, which are planned to identify the causes and their prevalence of certain conditions. Risk cannot be measured directly by the results of information evaluation in one person, but is calculated on the basis of selective observation of a group of persons who are under the influence (exposed group) of a certain factor. Risk factors are potentially pathogenic factors, in contact with which a person may develop a disease. A full analysis of pathological processes, assessment of risk factors and actual risks are impossible without prognosis, as well as multivariate analysis, which is often based on the probabilistic method of A. Wald or the survival curves construction. In practical health care, cases of medical and social research and in clinical studies, it is often necessary to identify the trends (predict) in changes of a certain condition. Conclusions. Determining the risk factors, calculating the actual risks and prognosis play an important role in medicine, because in the doctor’s practice there are daily situations that need to determine the optimal tactics taking into account trends, course, severity and results of treatment. Therefore, their definition/calculation must be clear and understandable. Depending on the case, the doctor can use the analysis of the score for certain factors, create risk groups, develop a monitoring plan, etc. As a result, it becomes possible to create a plan of preventive measures and timely correction of treatment.
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