Investigating the association between prior history of asthma and later diagnosis of COPD: an analysis of British Columbia administrative health database in Canada
Notice bibliographique
Résumé
Adult asthma patients are at an increased likelihood of being diagnosed with chronic obstructive pulmonary diseases (COPD) later in life. The main aim of this dissertation is to examine the factors associated with asthma patients that lead to COPD diagnosis later in life. The study was motivated by the dearth of research explaining the complex relationship between prior history of asthma and a later diagnosis of COPD. Similarly, there is a lack of academic literature and clinical research that examines the association between sub-optimal medication adherence (MA) in asthma patients and their subsequent risk of COPD. Additionally, there exists no gold standard with a clinical or pharmacological rationale for measuring optimal MA in asthma patients using pharmacy-based databases. In examining these critical research areas, meta-analysis and a retrospective observational cohort design were employed. Four linked databases obtained from the Population Data BC, spanning from January 1, 1998, to December 31, 2018, were used for data analysis. The meta-analysis showed that patients with a previous history of asthma were 7.87 times more likely to develop COPD in the future than were non-asthmatics. In addition, an analysis of the Population Data BC found that the following risk factors predicted COPD in asthma patients: “being an older adult (40 years and older)”, “being male and obese”, “a history of tobacco use”, “comorbidity burden”, “length of hospital stay”, “asthma severity levels”, “asthma exacerbations”, and overuse of Short-Acting Beta-2 Agonist (SABA). Also, the study identified medication possession ratio (MPR) and proportion of days covered (PDC) as the most commonly used methods for measuring medication adherence with higher sensitivity. The study identified an adherence threshold of at least 0.80 as optimal in categorizing adherent and non-adherent adult asthma patients. Further, patients who achieved a sub-optimal level of MA were at a significantly increased risk for developing COPD over time after adjusting for relevant confounders. Levels of asthma severity modified the MA effect. Additionally, overuse of short-acting beta-2 agonist (SABA) was significantly associated with an increased risk of COPD after adjusting for relevant confounders and covariates. This study’s findings provide important insights into the lifestyle and behavioural risk factors associated with COPD risk. Healthcare providers and policymakers should highlight the need for smoking cessation programs, weight management, and medication compliance interventions, particularly in difficult-to-control adult asthma patients who are at an elevated risk of developing COPD.
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 | 0,003 | 0,015 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,004 |
| Bibliométrie | 0,005 | 0,021 |
| Études des sciences et des technologies | 0,003 | 0,001 |
| Communication savante | 0,003 | 0,001 |
| Science ouverte | 0,003 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 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 ».