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数据合并在创伤后应激障碍(PTSD)早期纵向研究中的应用:国际创伤后应激障碍预测联盟(ICPP)项目

Application of data pooling to longitudinal studies of early post-traumatic stress disorder (PTSD): the International Consortium to Predict PTSD (ICPP) project.

作者信息

Qi Wei, Ratanatharathorn Andrew, Gevonden Martin, Bryant Richard, Delahanty Douglas, Matsuoka Yutaka, Olff Miranda, deRoon-Cassini Terri, Schnyder Ulrich, Seedat Soraya, Laska Eugene, Kessler Ronald C, Koenen Karestan, Shalev Arieh

机构信息

Department of Psychiatry, New York University School of Medicine, New York, NY, USA.

Department of Epidemiology, Columbia University Mailman School of Public Health, New York , USA.

出版信息

Eur J Psychotraumatol. 2018 Jun 14;9(1):1476442. doi: 10.1080/20008198.2018.1476442. eCollection 2018.

Abstract

: Understanding the development of post-traumatic stress disorder (PTSD) is a precondition for efficient risk assessment and prevention planning. Studies to date have been site and sample specific. Towards developing generalizable models of PTSD development and prediction, the International Consortium to Predict PTSD (ICPP) compiled data from 13 longitudinal, acute-care based PTSD studies performed in six different countries. : The objectives of this study were to describe the ICPP's approach to data pooling and harmonization, and present cross-study descriptive results informing the longitudinal course of PTSD after acute trauma. : Item-level data from 13 longitudinal studies of adult civilian trauma survivors were collected. Constructs (e.g. PTSD, depression), measures (questions or scales), and time variables (days from trauma) were identified and harmonized, and those with inconsistent coding (e.g. education, lifetime trauma exposure) were recoded. Administered in 11 studies, the Clinician Administered PTSD Scale (CAPS) emerged as the main measure of PTSD diagnosis and severity. : The pooled data set included 6254 subjects (39.9% female). Studies' average retention rate was 87.0% (range 49.1-93.5%). Participants' baseline assessments took place within 2 months of trauma exposure. Follow-up durations ranged from 188 to 1110 days. Reflecting studies' inclusion criteria, the prevalence of baseline PTSD differed significantly between studies (range 3.1-61.6%), and similar differences were observed in subsequent assessments (4.3-38.2% and 3.8-27.0% for second and third assessments, respectively). : Pooling data from independently collected studies requires careful curation of individual data sets for extracting and optimizing informative commonalities. However, it is an important step towards developing robust and generalizable prediction models for PTSD and can exceed findings of single studies. The large differences in prevalence of PTSD longitudinally cautions against using any individual study to infer trauma outcome. The multiplicity of instruments used in individual studies emphasizes the need for common data elements in future studies.

摘要

了解创伤后应激障碍(PTSD)的发展是进行有效风险评估和预防规划的前提条件。迄今为止的研究都是针对特定地点和样本的。为了建立可推广的PTSD发展和预测模型,国际PTSD预测联盟(ICPP)汇总了在六个不同国家进行的13项基于急性护理的PTSD纵向研究的数据。:本研究的目的是描述ICPP的数据汇总和协调方法,并呈现跨研究的描述性结果,以了解急性创伤后PTSD的纵向病程。:收集了13项关于成年平民创伤幸存者的纵向研究的项目级数据。对结构(如PTSD、抑郁症)、测量方法(问题或量表)和时间变量(创伤后天数)进行了识别和协调,对编码不一致的变量(如教育程度、终生创伤暴露情况)进行了重新编码。在11项研究中使用的临床医生管理的PTSD量表(CAPS)成为PTSD诊断和严重程度的主要测量方法。:汇总数据集包括6254名受试者(49.9%为女性)。各研究的平均保留率为87.0%(范围为49.1 - 93.5%)。参与者的基线评估在创伤暴露后2个月内进行。随访时长从188天到1110天不等。反映各研究的纳入标准,基线PTSD的患病率在各研究之间存在显著差异(范围为3.1 - 61.6%),在后续评估中也观察到类似差异(第二次和第三次评估分别为4.3 - 38.2%和3.8 - 27.0%)。:汇总独立收集的研究数据需要对各个数据集进行仔细整理,以提取和优化信息共性。然而,这是朝着建立强大且可推广的PTSD预测模型迈出的重要一步,并且可以超越单个研究的结果。PTSD患病率在纵向方面的巨大差异提醒我们不要使用任何单个研究来推断创伤结果。单个研究中使用的工具的多样性强调了未来研究中需要通用数据元素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e6f/6008580/2063d0350bbc/ZEPT_A_1476442_F0001_B.jpg

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