Comorbidity Differences by Trajectory Groups as a Reference for Identifying Patients at Risk for Late Mortality in Childhood Cancer Survivors: Longitudinal National Cohort Study
Notice bibliographique
Résumé
BACKGROUND: Childhood cancer has a high long-term morbidity and mortality rate. Five years after the initial cancer diagnosis, approximately two-thirds of childhood cancer survivors experience at least one late complication, with one-quarter experiencing severe, life-threatening complications. Chronic health conditions can impact survivors' life planning and daily activities, reducing their health-related quality of life. Comprehensive and longitudinal data are required for investigations of national claims data. OBJECTIVE: This study aimed to address clinical and health policy interventions and improved survival rates. A comprehensive categorization of the long-term morbidities associated with childhood cancer survivorship is required. We analyzed the trajectory groups associated with long-term mortality among childhood cancer survivors. METHODS: We collected data from a nationwide claims database of the entire Korean population. Between 2003 and 2007, patients diagnosed with and treated for cancer before the age of 20 years were included. With 8119 patients who survived >10 years, 3 trajectory groups were classified according to yearly changes in the number of diagnoses (the lowest in group 1 and the highest in group 3). RESULTS: The patterns of most comorbidities and survival rates differed significantly between the trajectory groups. Group 3 had a higher rate of mental and behavioral disorders, neoplasms, and blood organ diseases than the other two groups. Furthermore, there was a difference in the number of diagnoses by trajectory groups over the entire decade, and the disparity increased as the survival period increased. If a patient received more than four diagnoses, especially after the fourth year, the patient was likely to be assigned to group 3, which had the worst prognosis. Group 1 had the highest overall survival rate, and group 3 had the lowest (P<.001). Group 3 had the highest hazard ratio of 4.37 (95% CI 2.57-7.42; P<.001) in a multivariate analysis of late mortality. CONCLUSIONS: Our findings show that the pattern of comorbidities differed significantly among trajectory groups for late death, which could help physicians identify childhood cancer survivors at risk for late mortality. Patients with neoplasms, blood organ diseases, or mental and behavioral disorders should be identified as having an increased risk of late mortality. Furthermore, vigilance and prompt action are essential to mitigate the potential consequences of a child cancer survivor receiving four or more diagnoses within a year.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».