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哮喘患者态度剖析工具的开发与验证

Development and Validation of an Attitudinal-Profiling Tool for Patients With Asthma.

作者信息

David-Wang Aileen, Price David, Cho Sang Heon, Ho James Chung Man, Liam Chong Kin, Neira Glenn, Teh Pei Li

机构信息

Section of Pulmonary Medicine, University of the Philippines-Philippine General Hospital, Manila, Philippines.

Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK.

出版信息

Allergy Asthma Immunol Res. 2017 Jan;9(1):43-51. doi: 10.4168/aair.2017.9.1.43.

Abstract

PURPOSE

To develop a profiling tool which accurately assigns a patient to the appropriate attitudinal cluster for the management of asthma.

METHODS

Attitudinal data from an online survey of 2,467 patients with asthma from 8 Asian countries/region, aged 18-50 years, having had ≥2 prescriptions in the previous 2 years and access to social media was used in a discriminant function analysis to identify a minimal set of questions for the Profiling Tool. A split-sample procedure based on 100 sets of randomly selected estimation and validation sub-samples from the original sample was used to cross-validate the Tool and assess the robustness of its predictive accuracy.

RESULTS

Our Profiling Tool contained 10 attitudinal questions for the patient and 1 GINA-based level of asthma control question for the physician. It achieved a predictive accuracy of 76.2%. The estimation and validation sub-sample accuracies of 76.7% and 75.3%, respectively, were consistent with the tool's predictive accuracy at 95% confidence level; and their 1.4 percentage-points difference set upper-bound estimate for the degree of over-fitting.

CONCLUSIONS

The Profiling Tool is highly predictive (>75%) of the attitudinal clusters that best describe patients with asthma in the Asian population. By identifying the attitudinal profile of the patient, the physician can make the appropriate asthma management decisions in practice. The challenge is to integrate its use into the consultation workflow and apply to areas where Internet resources are not available or patients who are not comfortable with the use of such technology.

摘要

目的

开发一种能够准确地将患者归类到适当的态度群组以进行哮喘管理的分析工具。

方法

从8个亚洲国家/地区年龄在18至50岁之间、在过去2年中至少有2次处方且能使用社交媒体的2467名哮喘患者的在线调查中获取态度数据,用于判别函数分析,以确定该分析工具所需的最少问题集。基于从原始样本中随机选取的100组估计和验证子样本的拆分样本程序,用于对该工具进行交叉验证,并评估其预测准确性的稳健性。

结果

我们的分析工具包含10个针对患者的态度问题和1个基于全球哮喘防治创议(GINA)的医生哮喘控制水平问题。其预测准确率达到76.2%。估计子样本和验证子样本的准确率分别为76.7%和75.3%,在95%置信水平下与该工具的预测准确率一致;它们1.4个百分点的差异为过度拟合程度设定了上限估计。

结论

该分析工具对最能描述亚洲人群中哮喘患者的态度群组具有高度预测性(>75%)。通过识别患者的态度特征,医生在实际操作中可以做出适当的哮喘管理决策。挑战在于将其使用整合到咨询工作流程中,并应用于无法获取互联网资源或对使用此类技术不适应的患者所在地区。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfb2/5102835/26d91d1cb597/aair-9-43-g001.jpg

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