A predictive scoring instrument for tuberculosis lost to follow-up outcome.
BACKGROUND: Adherence to tuberculosis (TB) treatment is troublesome, due to long therapy duration, quick therapeutic response which allows the patient to disregard about the rest of their treatment and the lack of motivation on behalf of the patient for improved. The objective of this study was to d...
| Autores: | , , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2012 |
| País: | España |
| Institución: | Universidad de Málaga |
| Repositorio: | r-FISABIO. Repositorio Institucional de Producción Científica |
| OAI Identifier: | oai:dnet:r-fisabio___::7455799a039b0504eaffd359eaa173e8 |
| Acceso en línea: | https://fisabio.portalinvestigacion.com/publicaciones/20776 https://www.scopus.com/inward/record.uri?eid=2-s2.0-84865534492&doi=10.1186%2f1465-9921-13-75&partnerID=40&md5=0f6ec8f05075aa5612b1402ae3e4deb5 |
| Access Level: | acceso abierto |
| Palabra clave: | Adherence Lost to follow-up outcome Predictors Scoring system Tuberculosis Adolescent Adult Aged Aged, 80 and over Algorithms Emigration and Immigration Female Humans Lost to Follow-Up Male Marital Status Middle Aged Patient Compliance Patient Selection Spain Young Adult adult article cohort analysis comprehension female follow up human immigration independent living major clinical study male multicenter study outcome assessment patient attitude patient compliance predictive value prospective study receiver operating characteristic scoring system tuberculosis adolescent aged algorithm marriage middle aged migration patient selection statistics |
| Sumario: | BACKGROUND: Adherence to tuberculosis (TB) treatment is troublesome, due to long therapy duration, quick therapeutic response which allows the patient to disregard about the rest of their treatment and the lack of motivation on behalf of the patient for improved. The objective of this study was to develop and validate a scoring system to predict the probability of lost to follow-up outcome in TB patients as a way to identify patients suitable for directly observed treatments (DOT) and other interventions to improve adherence. METHODS: Two prospective cohorts, were used to develop and validate a logistic regression model. A scoring system was constructed, based on the coefficients of factors associated with a lost to follow-up outcome. The probability of lost to follow-up outcome associated with each score was calculated. Predictions in both cohorts were tested using receiver operating characteristic curves (ROC). RESULTS: The best model to predict lost to follow-up outcome included the following characteristics: immigration (1 point value), living alone (1 point) or in an institution (2 points), previous anti-TB treatment (2 points), poor patient understanding (2 points), intravenous drugs use (IDU) (4 points) or unknown IDU status (1 point). Scores of 0, 1, 2, 3, 4 and 5 points were associated with a lost to follow-up probability of 2,2% 5,4% 9,9%, 16,4%, 15%, and 28%, respectively. The ROC curve for the validation group demonstrated a good fit (AUC: 0,67 [95% CI; 0,65-0,70]). CONCLUSION: This model has a good capacity to predict a lost to follow-up outcome. Its use could help TB Programs to determine which patients are good candidates for DOT and other strategies to improve TB treatment adherence. |
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