何时痊愈？使用急性呼吸道感染问卷确定分界点。

IF 4.9 2区医学 Q1 ECONOMICS

Value in Health Pub Date : 2024-11-01 DOI:10.1016/j.jval.2024.07.002

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引用次数: 0

摘要

目的：急性呼吸道感染（ARTIs）是一类异质性疾病。通常情况下，在全科诊疗中很难获得准确诊断，也很难确定患者何时痊愈。由于缺乏对 ARTI 后康复的准确定义，使得旨在优化诊断和比较治疗方法的科学研究变得更加复杂。本研究旨在使用经过验证的患者报告结果（PRO）工具--急性呼吸道感染问卷（ARTIQ）--确定分界点，以确定 ARTI 的结束时间，作为在全科诊疗中被诊断为 ARTI 患者的康复时间：共有 259 名参与者被分为两组--一组患有 ARTI，另一组未患 ARTI。对 ARTIQ 的五个维度分别计算直方图和曲线下面积 (AUC)，以评估鉴别效果。对最具鉴别力的维度绘制了接收操作比较曲线（ROC），以确定有无 ARTI 症状的相关临界点，并在临床研究中作为康复的替代指标：结果：发现两个维度的判别效果最高：结果：在 "体征--上呼吸道 "和 "体征--下呼吸道 "这两个维度上发现了最高的分辨效果。将这两个维度结合起来，AUC 为 0.97。计算了选定截断点的敏感性、特异性和预测值：结论：利用 PRO 确定了作为 ARTI 康复替代指标的临界点。结论：利用 PRO 确定了作为 ARTI 康复替代指标的临界点。必须根据特定的临床情况为某个研究项目选择特定的临界点。

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When Are You Recovered? Defining Cutoff Points Using the Acute Respiratory Tract Infection Questionnaire

Objectives

Acute respiratory tract infections (ARTIs) are a heterogenous group of diseases. Often, it is difficult to obtain a precise diagnosis in general practice but also difficult to determine when the patient is recovered. The lack of a precise definition of recovery after ARTI complicates scientific research aiming to optimize diagnostics and compare treatments. The study aimed to define cutoff points to determine the end of an ARTI as a proxy for recovery in patients diagnosed with ARTI in general practice using a validated patient-reported outcome instrument; The ARTI Questionnaire (ARTIQ).

Methods

A total of 259 participants was divided in 2 groups—1 with ARTI and 1 without. Histograms and area under the curve were calculated for each of the 5 dimensions within the ARTIQ to evaluate the discriminative effect. For the most discriminative dimensions receiver operating comparison curves were performed to determine relevant cutoff points for having or not having ARTI symptoms and serve as a proxy for recovery in clinical research.

Results

The highest discriminative effect was found in 2 dimensions: “physical—upper airways” and “physical—lower airways.” When combining these dimensions, the area under the curve was 0.97. Sensitivity, specificity, and predictive values were calculated for selected cutoff points.

Conclusion

Cutoff points serving as proxy for recovery from ARTI using a patient-reported outcome were identified. The specific cutoff point for a certain research project must be selected considering the specific clinical situation of interest.

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来源期刊

Value in Health 医学-卫生保健

CiteScore

6.90

自引率

6.70%

发文量

3064

审稿时长

3-8 weeks

期刊介绍： Value in Health contains original research articles for pharmacoeconomics, health economics, and outcomes research (clinical, economic, and patient-reported outcomes/preference-based research), as well as conceptual and health policy articles that provide valuable information for health care decision-makers as well as the research community. As the official journal of ISPOR, Value in Health provides a forum for researchers, as well as health care decision-makers to translate outcomes research into health care decisions.