Liza M Y Gelissen, Robin van den Bergh, Amir H Talebi, Angelika D Geerlings, Bart R Maas, Myrthe M Burgler, Yvet Kroeze, Agnes Smink, Bastiaan R Bloem, Marten Munneke, Yoav Ben-Shlomo, Sirwan K L Darweesh
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引用次数: 0
摘要
简介PRIME-NL 研究对荷兰选定地区(PRIME)帕金森病患者(包括帕金森病)的新型综合个性化护理模式进行了前瞻性评估。我们通过研究基线数据和 1 年达标数据,探讨了 PRIME-NL 研究的可推广性以及选择偏差和混杂偏差的来源:首先,我们利用荷兰几乎所有帕金森病患者(源人群)的医疗报销数据,评估了 PRIME 和常规护理(UC)地区之间的地区基线差异。其次,我们将问卷样本与来源人群进行了比较,以确定可推广性。第三,我们通过比较 PRIME 和 UC 问卷样本的基线特征和 1 年依从性来研究偏差来源:结果:PRIME(n = 1430)和 UC(n = 26250)来源人群的基线特征相似。综合问卷样本(n = 920)比综合来源人群更年轻,病程稍长。与 PRIME 地区的问卷样本相比,UC 的问卷样本略显年轻,认知能力更强,病程更长,教育程度更高,饮酒量更大。UC地区问卷样本的1年依从性(96%)高于PRIME地区(92%):PRIME-NL研究的普适性似乎不错,但我们也发现了一些选择偏差的证据。因此,在对 PRIME-NL 进行最终评估时,有必要使用先进的统计方法,如反概率加权法或倾向得分匹配法。PRIME-NL 研究为慢性病患者(这里指帕金森病患者)进行大规模护理评估的有效性提供了一个独特的窗口。
Assessing the validity of a Parkinson's care evaluation: the PRIME-NL study.
Introduction: The PRIME-NL study prospectively evaluates a new integrated and personalized care model for people with parkinsonism, including Parkinson's disease, in a selected region (PRIME) in the Netherlands. We address the generalizability and sources of selection and confounding bias of the PRIME-NL study by examining baseline and 1-year compliance data.
Methods: First, we assessed regional baseline differences between the PRIME and the usual care (UC) region using healthcare claims data of almost all people with Parkinson's disease in the Netherlands (the source population). Second, we compared our questionnaire sample to the source population to determine generalizability. Third, we investigated sources of bias by comparing the PRIME and UC questionnaire sample on baseline characteristics and 1-year compliance.
Results: Baseline characteristics were similar in the PRIME (n = 1430) and UC (n = 26,250) source populations. The combined questionnaire sample (n = 920) was somewhat younger and had a slightly longer disease duration than the combined source population. Compared to the questionnaire sample in the PRIME region, the UC questionnaire sample was slightly younger, had better cognition, had a longer disease duration, had a higher educational attainment and consumed more alcohol. 1-year compliance of the questionnaire sample was higher in the UC region (96%) than in the PRIME region (92%).
Conclusion: The generalizability of the PRIME-NL study seems to be good, yet we found evidence of some selection bias. This selection bias necessitates the use of advanced statistical methods for the final evaluation of PRIME-NL, such as inverse probability weighting or propensity score matching. The PRIME-NL study provides a unique window into the validity of a large-scale care evaluation for people with a chronic disease, in this case parkinsonism.
期刊介绍:
The European Journal of Epidemiology, established in 1985, is a peer-reviewed publication that provides a platform for discussions on epidemiology in its broadest sense. It covers various aspects of epidemiologic research and statistical methods. The journal facilitates communication between researchers, educators, and practitioners in epidemiology, including those in clinical and community medicine. Contributions from diverse fields such as public health, preventive medicine, clinical medicine, health economics, and computational biology and data science, in relation to health and disease, are encouraged. While accepting submissions from all over the world, the journal particularly emphasizes European topics relevant to epidemiology. The published articles consist of empirical research findings, developments in methodology, and opinion pieces.