Abstract:Objective To analyze the trend of treatment quality of invasive breast cancer using joinpoint regression, and provide reference for standardizing medical practice behavior and formulating improvement measures for breast cancer treatment quality.Methods Data of invasive breast cancer patients were collected. The utilization rate of each indicator was calculated based on the evaluation indicators of treatment quality of invasive breast cancer, and the denominator-based weight was used to obtain the comprehensive score. Joinpoint regression was used to analyze the trend of hospitallevel treatment quality of invasive breast cancer.Results Data of 2 349 patients from 6 hospitals from 2011 to 2013 were collected. The top three indicators with high utilization rate related to diagnostic examination of axillary lymph node dissection were preoperative molybdenum target or ultrasound (99.16%), no postoperative complications (98.38%), tumor diameter recorded in the pathology report (98.28%), and the lowest rate of the utilization of postmastectomy radiotherapy (33.33%). Hospital E has the highest composite score (0.94) and hospital F has the lowest score (0.77). Results of trend analysis showed that the trend of quality of care for invasive breast cancer has increased slowly (MPC=0.12, P=0.003), and trends of different hospitals varied, among which the quality of care of hospital C increased monthly (MPC=0.10, P=0.031), hospital D increased before November 2012(MPC=0.91, P=0.001), and hospital E declined before October 2011(MPC=-2.05, P=0.004).Conclusion Compared with the conventional regression methods, joinpoint regression could be used to evaluate the trend of quality of care for invasive breast cancer over different time periods in more detail and find the key nodes of the decrease of the treatment quality. Combined with the utilization rate of indicators and the composite score of hospitals, joinpoint regression could be used to analyze the reasons for the adverse trend of quality of care, and provide a theoretical basis for standardizing the behavior of medical practice and improving the quality of care.
郭瑞泽,王超,栗景坤,魏丽,侯爽,刘美娜. 基于joinpoint回归分析浸润性乳腺癌治疗质量变化趋势[J]. 中国医院统计, 2022, 29(5): 325-330.
Guo Ruize, Wang Chao, Li Jingkun, Wei Li, Hou Shuang, Liu Meina. Trend of treatment quality of invasive breast cancer based on joinpoint regression. journal1, 2022, 29(5): 325-330.
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