Rakowski W, Clark M A
Department of Community Health, Brown University, Providence, RI, 02912, USA.
Am J Prev Med. 1998 Oct;15(3):187-97. doi: 10.1016/s0749-3797(98)00048-8.
As mammography rates increase, an important question is how closely groups of women match or do not match the national-level, average screening percentage.
This study employed a classification-tree methodology to combine individual risk factors from multiple logistic regression, in order to more comprehensively define groups of women less (or more) likely to be screened.
DESIGN/SETTING: This report was a secondary data analysis drawing on data from the 1992 National Health Interview Survey, Cancer Control Supplement (NHIS-CCS).
Analyses examined mammography status of women aged 50-75 (n = 1,727).
The dependent variable was having a screening mammogram in the past 2 years. Multiple logistic regression (SUDAAN) was conducted first to select significant correlates of screening. A classification-tree analysis (CHAID subroutine of SPSS) was then used to combine the significant correlates into exclusive and exhaustive subgroups.
A total of 13 subgroups were identified, of which only six approximated the overall population screening rate. The lowest screening occurred in small clusters of women, which, when added together, formed a larger percentage of the population who were not screened within the past 2 years.
Efforts to increase mammography may face the challenge of identifying relatively small pockets of women and addressing their individual barriers. Further work should be done to find efficient ways to combine individual risk factors into groups at risk for not being screened.
随着乳房X光检查率的提高,一个重要问题是不同女性群体与国家层面的平均筛查百分比的匹配程度如何。
本研究采用分类树方法,将多个逻辑回归中的个体风险因素结合起来,以便更全面地定义筛查可能性较低(或较高)的女性群体。
设计/背景:本报告是一项利用1992年全国健康访谈调查癌症控制补充调查(NHIS-CCS)数据进行的二次数据分析。
分析调查了50至75岁女性(n = 1727)的乳房X光检查状况。
因变量是过去两年内是否进行过乳房X光筛查。首先进行多元逻辑回归(SUDAAN)以选择筛查的显著相关因素。然后使用分类树分析(SPSS的CHAID子程序)将显著相关因素组合成相互排斥且详尽无遗的亚组。
共识别出13个亚组,其中只有6个亚组的筛查率接近总体人群筛查率。最低筛查率出现在小群体女性中,这些小群体女性加起来在过去两年内未接受筛查的人群中占比更大。
提高乳房X光检查率的努力可能面临识别相对较小女性群体并解决其个体障碍的挑战。应进一步开展工作,找到将个体风险因素有效组合成未筛查风险群体的方法。