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首页> 外文期刊>Psychosomatics >Clinically Feasible Stratification of 3-Year Chronic Disease Risk in Primary Care: The Mental Health Integration Risk Score
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Clinically Feasible Stratification of 3-Year Chronic Disease Risk in Primary Care: The Mental Health Integration Risk Score

机译：3年初级保健3年慢性疾病风险的临床可行分层：心理健康一体化风险评分

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Background: Depression is a common illness that imposes a disproportionately large health burden. Depression is generally associated with a higher prevalence of chronic disease risk factors and may contribute to higher chronic disease risk. Objective: This study aimed to create and validate sex-specific Mental Health Integration Risk Scores (MHIRS) that predict 3-year chronic disease diagnosis. Methods: MHIRS was created to predict the first diagnosis of any of the 10 chronic diseases in patients completing a Patient Health Questionnaire-9 Depression Survey who were free at baseline from those 10 chronic disease diagnoses. MHIRS used sex-specc weightings of Patient Health Questionnaire 9 results, age, and components of the complete metabolic profile and complete blood count in randomly chosen derivation (70%) and validation (30%) groups. Results: Among females (N = 10,162, age: 48 +/- 16), c-statistics for the composite chronic disease end point were 0.746 (0.725, 0.767) for the derivation group and 0.717 (0.682, 0.753) for the validation group, whereas males (N = 4615, age: 48 +/- 15) had 0.755 (0.727, 0.783) and 0.742 (0.702, 0.782). In the validation group, MHIRS strata of low-, moderate-, and high-risk categories had hazard ratios (HR) for any 3-year chronic disease diagnosis among females of HR = 3.42 for moderate vs low and HR = 9.75 for high vs low, whereas males had HR = 4.80 and HR = 10.68, respectively (all p < 0.0001). Conclusion: A clinical decision tool comprised by depression severity and common laboratory tests, and MHIRS provides very good stratcation of a 3-year chronic disease diagnosis. Designed to be calculated electronically by an electronic health record, MHIRS can be efficiently obtained by clinicians to identify patients at higher chronic disease risk who require further evaluation and more precise clinical management.
机译：背景：抑郁症是一种常见的疾病，造成了不成比例的健康负担。抑郁症通常与慢性疾病风险因素的患病率较高，可能有助于较高的慢性疾病风险。目的：本研究旨在创造和验证性别特定的心理健康一体化风险评分（MHIR），预测3年慢性疾病诊断。方法：创建了MHIR，以预测完成患者健康调查问卷-9患者的10例慢性疾病的第一次诊断，该调查来自那些慢性疾病诊断的基线。 MHIRS使用患者健康调查问卷的性别标准的性别调查9结果，年龄和组件的完全代谢型材和随机选择的衍生（70％）和验证（30％）组的完整血统计数。结果：在雌性慢性疾病终点的雌性（n = 10,162，年龄：48 +/-16）中，衍生物组的C统计为0.746（0.725,0.767），验证组0.717（0.682,0.753） ，而男性（n = 4615，年龄：48 +/- 15）有0.755（0.727,0.783）和0.742（0.702,0.782）。在验证组中，低，中等和高风险类别的MHIRS阶层具有危害比率（HR），对于HR = 3.42的女性，对于中等VS低，HR = 9.75，高VS的任何3年慢性疾病诊断低，而雄性分别具有HR = 4.80和HR = 10.68（所有P <0.0001）。结论：抑郁症严重性和常见实验室检测组成的临床决策工具，MHIRS提供了3年慢性疾病诊断的良好分层。设计用于通过电子健康记录以电子方式计算，MHIRS可以通过临床医生有效地获得，以确定需要进一步评估和更精确的临床管理的慢性疾病风险较高的患者。

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