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《乳房植入病患者自述:美国食品和药物管理局不良事件报告系统十年回顾》。

The Patient Narrative for Breast Implant Illness: A 10-Year Review of the U.S. Food and Drug Administration's MAUDE Database.

机构信息

From the Department of Surgery, Duke University, School of Medicine; Department of Mathematics, Department of Biostatistics and Bioinformatics, and Department of Surgery, Division of Plastic, Oral, and Maxillofacial Surgery, and Duke Cancer Institute, Duke University.

出版信息

Plast Reconstr Surg. 2022 Dec 1;150(6):1181-1187. doi: 10.1097/PRS.0000000000009694. Epub 2022 Sep 15.

Abstract

BACKGROUND

There is growing recognition of a condition known as breast implant illness. Very little information exists about the diagnosis and natural history of breast implant illness. To better understand the patient experience, we surveyed the U.S. Food and Drug Administration's Manufacturer and User Facility Device Experience (MAUDE) database for narratives describing symptoms of breast implant illness.

METHODS

The MAUDE database was queried for all reports that included breast implant illness within the patient narrative between 2010 and 2020. A review of narratives was used to identify and summarize 36 symptoms over nine symptom classes. Event year and reporting year were summarized. Hierarchical clustering analysis using centroid components was conducted on all reported breast implant illness symptoms, and a dendrogram was created to visualize clustering.

RESULTS

During the study period from 2010 to 2020, there were 751 captured adverse event reports in the MAUDE database that referenced breast implant illness, with the first report submission in 2014. Of those reports, 60.6 percent were for silicone implants and 39.4 percent were for saline implants. The three most commonly reported symptom categories were neurologic [ n = 544 (72.4 percent)], followed by musculoskeletal [ n = 418 (55.7 percent)], and dermatologic [ n = 273 (36.4 percent)]. The top 10 symptoms, irrespective of category, include fatigue/weakness, numbness/tingling, brain fog, depression/anxiety, arthralgia, myalgia, headache, hair loss, gastrointestinal issues, and weight change. A hierarchical clustering analysis demonstrated that symptoms reported by patients clustered into two major groups.

CONCLUSION

This study demonstrates the utility of public-facing databases, such as the Manufacturer and User Facility Device Experience database, in understanding the patient experience as it relates to breast implant illness.

摘要

背景

人们越来越意识到一种被称为乳房植入病的病症。关于乳房植入病的诊断和自然病史,几乎没有信息。为了更好地了解患者的体验,我们调查了美国食品和药物管理局的制造商和用户设施设备体验(MAUDE)数据库,以获取描述乳房植入病症状的叙述。

方法

在 2010 年至 2020 年期间,MAUDE 数据库中查询了所有报告,其中患者叙述中包含乳房植入病。通过对叙述的审查,确定并总结了 9 个症状类别中的 36 种症状。总结了事件年份和报告年份。对所有报告的乳房植入病症状进行了基于质心成分的层次聚类分析,并创建了一个聚类图来可视化聚类。

结果

在 2010 年至 2020 年的研究期间,MAUDE 数据库中有 751 份与乳房植入病相关的不良事件报告,首次报告提交于 2014 年。这些报告中,60.6%为硅胶植入物,39.4%为盐水植入物。报告中最常见的三个症状类别为神经学[ n = 544(72.4%)],其次是肌肉骨骼[ n = 418(55.7%)]和皮肤学[ n = 273(36.4%)]。前 10 种症状,不论类别,包括疲劳/乏力、麻木/刺痛、脑雾、抑郁/焦虑、关节痛、肌痛、头痛、脱发、胃肠道问题和体重变化。层次聚类分析表明,患者报告的症状聚类为两个主要组。

结论

本研究表明,公共数据库(如制造商和用户设施设备体验数据库)在理解与乳房植入病相关的患者体验方面具有实用性。

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