Gottlieb Assaf, Yatsco Andrea, Bakos-Block Christine, Langabeer James R, Champagne-Langabeer Tiffany
School of Biomedical Informatics, University of Texas Health Science Center at Houston, 7000 Fannin St., Houston, TX 77030, USA.
McGovern Medical School, University of Texas Health Science Center at Houston, 6431 Fannin St., Houston, TX 77030, USA.
Healthcare (Basel). 2022 Jan 25;10(2):223. doi: 10.3390/healthcare10020223.
An increase in opioid use has led to an opioid crisis during the last decade, leading to declarations of a public health emergency. In response to this call, the Houston Emergency Opioid Engagement System (HEROES) was established and created an emergency access pathway into long-term recovery for individuals with an opioid use disorder. A major contributor to the success of the program is retention of the enrolled individuals in the program.
We have identified an increase in dropout from the program after 90 and 120 days. Based on more than 700 program participants, we developed a machine learning approach to predict the individualized risk for dropping out of the program.
Our model achieved sensitivity of 0.81 and specificity of 0.65 for dropout at 90 days and improved the performance to sensitivity of 0.86 and specificity of 0.66 for 120 days. Additionally, we identified individual risk factors for dropout, including previous overdose and relapse and improvement in reported quality of life.
Our informatics approach provides insight into an area where programs may allocate additional resources in order to retain high-risk individuals and increase the chances of success in recovery.
在过去十年中,阿片类药物使用的增加导致了阿片类药物危机,引发了公共卫生紧急状态的声明。为响应这一呼吁,休斯顿紧急阿片类药物参与系统(HEROES)得以建立,并为患有阿片类药物使用障碍的个人创建了一条通往长期康复的紧急接入途径。该项目成功的一个主要因素是已登记人员在项目中的留存率。
我们发现项目在90天和120天后的退出率有所上升。基于700多名项目参与者,我们开发了一种机器学习方法来预测个体退出项目的风险。
我们的模型在90天时对退出的预测灵敏度为0.81,特异性为0.65,到120天时性能有所提升,灵敏度为0.86,特异性为0.66。此外,我们还确定了退出的个体风险因素,包括既往过量用药、复发以及报告的生活质量改善情况。
我们的信息学方法为项目可能分配额外资源以留住高风险个体并增加康复成功几率的领域提供了见解。