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首页> 外文期刊>HIV medicine >The use of funnel plots with regression as a tool to visually compare HIV treatment outcomes between centres adjusting for patient characteristics and size: a UK Collaborative HIV Cohort study
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The use of funnel plots with regression as a tool to visually compare HIV treatment outcomes between centres adjusting for patient characteristics and size: a UK Collaborative HIV Cohort study

机译：使用漏斗情节与回归作为在视觉上比较患者特征和尺寸的中心之间的艾滋病治疗结果的工具：英国合作艾滋病毒队列研究

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摘要

Objectives A measure used for assessing the effectiveness of HIV care and comparing clinical centres is the proportion of people starting antiretroviral therapy ( ART ) with viral suppression ( VS ) after 1 year. We propose a method that adjusts for patients’ demographic characteristics, and visually compares this measure between different sites accounting for centre size. Methods We analysed viral load measurements for UK Collaborative HIV Cohort ( UK CHIC ) patients starting ART between 2006 and 2013. We used logistic regression to estimate the proportion with VS after 1 year of ART adjusted for patient mix (in terms of age and a combined gender/ethnicity/acquisition mode variable) and calendar year. We compared outcomes between centres using funnel plots which account for centre size. Results The overall proportion of the cohort with VS 1 year after starting ART was 90% and increased from 83% to 93% between 2006 and 2013. VS was lower in younger individuals. White men who have sex with men ( MSM ) had the highest (94%), and black African (81%) and white (82%) heterosexual women the lowest proportions achieving VS . Comparing the unadjusted funnel plot with the adjusted, there were movements of some centres from outside to inside the 95% contour limits, which was largely explained by the patient mix of these centres. Conclusions VS 1 year after ART start was associated with demographic characteristics and centre size; therefore, to compare the performances of centres, adjustment for these factors is required. Adjusted funnel plot is an effective tool which accounts for both the demographic characteristics and the centre size. Social factors, rather than treatment decisions within the control of the centres, may drive differences in outcomes.
机译：目的是用于评估艾滋病毒护理和比较临床中心的有效性的措施是在1年后开始抗逆转录病毒治疗（艺术）的人们在病毒抑制（VS）中的比例。我们提出了一种调整患者人口特征的方法，目视比较不同地点之间的这种措施，占中心大小的核算。方法对2006年至2013年之间的英国协作HIV队列（英国ChiC）患者的病毒载量分析了英国协作艾滋病毒队（UK ChiC）患者的病毒载量测量。我们使用Logistic回归在为患者混合调整的艺术术后与VS的比例估算（在年龄和组合方面性别/民族/采集模式变量）和日历年。我们使用漏斗绘图与中心尺寸的漏斗块进行比较结果。结果起始艺术后1年的队列的总体比例为90％，从2006年至2013年之间增加了83％至93％。较年轻个体较低。与男人（MSM）发生性关系的白人（MSM）最高（94％）和黑色非洲（81％）和白色（82％）异性恋女性，这是实现与vs的最低比例。将不调整的漏斗绘图与调整的调节进行比较，从外部到95％的轮廓限制内部有一些中心的运动，这主要由这些中心的患者混合来解释。结论艺术开始后1年与人口统计特征和中心大小相关;因此，为了比较中心的表演，需要对这些因素进行调整。调整后的漏斗绘图是一个有效的工具，其占人口特征和中心大小。社会因素，而不是在控制中心的控制范围内的治疗决策可能会导致结果的差异。

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  • 来源
    《HIV medicine》 |2018年第6期|共9页
  • 作者

    Gompels M; Michael S; Jose S; Hill T; Trevelion R; Sabin CA; May MT;

  • 作者单位

    Southmead HospitalNorth Bristol NHS TrustBristol UK;

    School of MathematicsUniversity of BristolBristol UK;

    Research Department of Infection and Population HealthUniversity College LondonLondon UK;

    Research Department of Infection and Population HealthUniversity College LondonLondon UK;

    HIV i‐BaseLondon UK;

    Research Department of Infection and Population HealthUniversity College LondonLondon UK;

    Department of Population Health SciencesUniversity of BristolBristol UK;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 传染病;
  • 关键词

    antiviral therapy; funnel plot; HIV; quality of care; viral suppression;

    机译：抗病毒治疗;漏斗情节;艾滋病毒;护理质量;病毒抑制;

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