Articles from rubric: «Modeling and forecasting»
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2023 № 11 A mathematical model for assessing the contribution of viral hepatitis to the formation of infectious penitentiary syndrome.
P u r p o s e : to study the role of viral hepatitis in the development and course of comorbid infection (disease caused by HIV, tuberculosis and parenteral viral hepatitis) in persons serving the penalty of deprivation of liberty.
M e t h o d s . The indicators reflecting the epidemic situation of tuberculosis, HIV infection and parenteral viral hepatitis in institutions of the Russian penal system were analyzed. Correlation analysis and multiple regression analysis were conducted, followed by an analysis of the quality of the obtained regression models (calculation of the coefficient of determination).
R e s u l t s . The following parameters have the maximum correlation between the predictors and the response function in this group of observations, with the subsequent exclusion of factors whose correlation with the variables involved in the calculations was higher than the correlation of these indicators with the response function: the incidence of hepatitis B per 100 thousand people (r = 0,86) [X1], the number of newly diagnosed hepatitis C patients in 2021 (r = 0,85) [X2], the proportion of newly diagnosed HIV-infected people in combination with tuberculosis and viral hepatitis (B, C, B+D), % (r = 0,85) [X3], the number of HIV patients receiving ART (r = 0,85) [X4], the incidence of tuberculosis in Pre-trial detention center (PTDC), per 100 thousand people (r=0,41) [X5], the number of newly arrested tuberculosis patients identified during the initial examination (r = 0,41) [X6]. The model was obtained: simulated mortality from HIV = –6,7 + 0,48 * X1 + 0,39 * X3 – 0,07 * X5 (R2 = 0,86). A similar model was obtained for the absolute values of the number of deaths; it involved the following parameters: the number of newly diagnosed patients with viral hepatitis B [X1], the
number of newly diagnosed patients with viral hepatitis C [X2], the number of newly diagnosed HIV patients in combination with tuberculosis [X3], the number of patients burdened by premorbid background (injecting drug users) [X4]: The number of deaths from HIV= –0,36 + 0,06 * X1 + 0.02 * X2 + 0.36 * X3 + 0,03 * X4 (R2 = 0.91).
C o n c l u s i o n . The association of HIV mortality rate with viral hepatitis and tuberculosis incidence is shown and estimated. HIV mortality can be considered as a function of the following factors: 1) the incidence of hepatitis B, 2) the proportion of first-time detected persons with HIV-tuberculosis-viral hepatitis coinfection, and 3) the incidence of tuberculosis in pre-trial detention centers. -
2023 № 11 Methodological principles of determining the directions of development of primary healthcare in the Russian Federation based on the cognitive matrix.
The main approaches to assessing the level of development of primary health care (PHC) in the Russian Federation generally correspond to global trends, however, to a greater extent it is still concentrated on individual areas and not fully systematized. To solve this problem and create a common methodological basis for determining the most acceptable classification features for the Russian Federation, allowing to verify the current state of PHC, identify problem areas and gaps in its development, as well as to form priorities for scientific and practical research and public policy, it seems appropriate to develop a unified cognitive matrix of taxonomic features for the analysis and evaluation
of PHC based on at the country level.
O b j e c t i v e . To develop a cognitive matrix of taxonomic features for the analysis and evaluation of PHC in the Russian Federation based on international approaches to assessing the level of PHC development, the conceptual structural hierarchy and concrete steps to achieve the targets laid down in the strategic documents of the Russian Federation and elements of the healthcare system studied in scientific researches.
M a t e r i a l s a n d m e t h o d s . Based on the previously prepared analytical review of WHO strategic documents, scientific research and publications [1, 2] by correlating with them on the principles of semantic or logical identity attributes, indicators, criteria or measures that determine the directions for research and evaluation of the current level of PHC development and directions of its prospective development, a content analysis of domestic publications (n = 41,824) with subsequent terminological adaptation.
R e s u l t s . A cognitive matrix of taxonomic features has been developed to analyze and assess the current level of PHC development in the Russian Federation, as well as to search for existing gaps for concentrating the efforts of health policy makers and the scientific community in solving the problems of its long-term development.
C o n c l u s i o n . The cognitive matrix of taxonomic features for the analysis and evaluation of PHC in the Russian Federation is a working tool for researchers, specialists of executive and legislative authorities in the field of health protection, experts in the field of health care and public health, allowing to determine the degree of study of certain areas of PHC, to identify gaps and unresolved legal provisions that create obstacles to its effective functioning and long-term development, directions for new fundamental and applied research, to unify approaches to determining priorities in the implementation of public policy. -
2023 № 11 Prediction of the risk of an unfavorable outcome in COVID‑19 using the classification tree method, taking into account the age and number of comorbid pathology according to the infectious hospital.
Objective: to determine the probability of the risk of an unfavorable outcome using the classification tree method in patients with COVID‑19 who were treated in an infectious hospital based on the analysis of the contribution of such predictors as age and the amount of comorbid pathology.
Materials and methods. The data of outpatient records of 5304 patients who were treated in an infectious diseases hospital with a diagnosis of COVID‑19 from January 1, 2021 to January 1, 2022 were analyzed. The age of the examined patients was 62 [56–66] years. Among 5,304 patients, there were 2,891 males (54,5%) and 2,413 females (45,5%). The patients were divided into age groups according to the WHO classification. The frequency of comorbid pathology was analyzed taking into account the nosological unit of the disease registered in at least 1% of the patients included in the study.
Results. In the studied sample, the elderly prevailed in a larger percentage – 46.8%. The presence of one or more comorbid pathology was revealed in the prevailing number of hospitalized – in 5,244 people (98,9%). The most common comorbid pathology in the examined patients was arterial hypertension in 2038 people (38,4%), coronary heart disease in 1997 people (37,7%) and type 2 diabetes mellitus in 1629 people (30,7%). A classification tree was constructed to predict the risk of the probability of an unfavorable outcome in patients with COVID‑19.The minimum number of observations in the parent node in the classification tree was 400 people, in the child node – 200 people. In the resulting classification tree, 8 terminal nodes were observed.
Conclusion. The probability of the risk of an unfavorable outcome in the analyzed sample of patients increases with an increase in the number of comorbid pathology and the age of patients. According to the forecast using the classification tree method, the greatest probability of risk (3,2 times) of an unfavorable outcome in relation to the general sample was among elderly persons+centenarians with more than three comorbid pathology. The developed classification tree showed a high probability of correct predictions (80%). The sensitivity of the resulting model was 77,9%, the specificity was 64,2%.