基于决策树的乳腺癌患者功能锻炼依从性预测模型
Predictive Model of Functional Exercise Compliance of Patients with Breast Cancer Based on Decision Tree.
作者信息
Luo Zebing, Luo Baolin, Wang Peiru, Wu Jinhua, Chen Chujun, Guo Zhijun, Wang Yiru
机构信息
Nursing Department, Cancer Hospital of Shantou University Medical College, Shantou City, People's Republic of China.
Nursing Department, Guangdong Provincial Key Laboratory of Breast Cancer Diagnosis and Treatment, Shantou City, People's Republic of China.
出版信息
Int J Womens Health. 2023 Mar 21;15:397-410. doi: 10.2147/IJWH.S386405. eCollection 2023.
OBJECTIVE
Regular functional exercise can help recover the functions of upper limb for patients with breast cancer. By finding the influencing factors of functional exercise compliance and constructing a predictive model, patients with a poor functional exercise compliance can be better identified. This study aims to find out the factors influencing the functional exercise compliance of patients with breast cancer and build a predictive model based on decision tree.
METHODS
Convenience sampling was used at two tertiary hospitals in Shantou from August 2020 to March 2021. Data of patients with breast cancer patient was obtained from questionnaires and based on demographics, Constant-Murley Score, Functional Exercise Compliance Scale for Postoperative Breast Cancer Patients, Champion Health Belief Model Scale, Social Support Rating Scale, Disease Perception Questionnaire and Family Care Index Questionnaire. Possible influencing factors of functional exercise compliance were analyzed using correlation analysis as well as univariate and binary logistic regression analysis through SPSS v25, and a CHAID decision tree was used to construct a predictive model on training, validation and test sets via SPSS Modeler v18 at a ratio of 6:2:2. Prediction accuracy, sensitivity, specificity and AUC were used to analyze the efficacy of the predictive model.
RESULTS
A total of 227 valid samples were collected, of which 145 were assessed with a poor compliance (63.9%). According to a logistic regression analysis, perceived benefits, time after surgery and self-efficacy were influencing factors. The prediction accuracy, sensitivity, specificity and AUC of the predictive model, based on a CHAID decision tree analysis, were 70.73%, 57.1%, 77.8% and 0.81 respectively.
CONCLUSION
The predictive model, based on a CHAID decision tree analysis, had a moderate predictive efficacy, which could be used as a clinical auxiliary tool for clinical nurses to predict patients' functional exercise compliance.
目的
规律的功能锻炼有助于乳腺癌患者上肢功能的恢复。通过找出功能锻炼依从性的影响因素并构建预测模型，可以更好地识别功能锻炼依从性差的患者。本研究旨在找出影响乳腺癌患者功能锻炼依从性的因素，并构建基于决策树的预测模型。
方法
2020年8月至2021年3月在汕头的两家三级医院采用便利抽样法。通过问卷调查获取乳腺癌患者的数据，问卷基于人口统计学、Constant-Murley评分、乳腺癌术后患者功能锻炼依从性量表、Champion健康信念模式量表、社会支持评定量表、疾病感知问卷和家庭关怀指数问卷。使用SPSS v25通过相关性分析以及单因素和二元逻辑回归分析功能锻炼依从性的可能影响因素，并通过SPSS Modeler v18以6:2:2的比例在训练集、验证集和测试集上使用CHAID决策树构建预测模型。使用预测准确性、敏感性、特异性和AUC分析预测模型的效果。
结果
共收集到227个有效样本，其中145个被评估为依从性差（63.9%）。根据逻辑回归分析，感知益处、术后时间和自我效能感是影响因素。基于CHAID决策树分析的预测模型的预测准确性、敏感性、特异性和AUC分别为70.73%、57.1%、77.8%和0.81。
结论
基于CHAID决策树分析的预测模型具有中等预测效能，可作为临床护士预测患者功能锻炼依从性的临床辅助工具。
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