基于层次聚类的保乳手术患者治疗质量评价及影响因素分析

doi:10.3969/j.issn.1006-5253.2021.05.003

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Abstract Objective To cluster the patients undergoing breast conserving surgery by hierarchical clustering, determine the treatment quality of each group combined with the average utilization rate of evaluating indicators, analyze the influence factors for the treatment quality, and provide theoretical guidance for improving the treatment quality for breast conserving surgery patients. Methods We selected quality evaluation indicators of breast conserving surgery, and collected medical records of breast conserving surgery patients; the patients were clustered by using the Jaccard similarity coefficient, and the average utilization rates were calculated to determine the level of the treatment quality based on denominator-based weight method; we also analyzed the influence factors of the treatment quality using multiple logistic regression. Result Two hundred and seventy-nine patients were selected and divided into two groups based on hierarchical clustering: group 1 was the low-quality group with 108 patients, accounting for 38.7%, and the average utilization rate of evaluation indicators was 68.4%; group 2 was the high-quality group with 171 patients, accounting for 61.3%, and the average utilization rate of evaluation indicators was 89.1%. The indicators with significant difference in the utilization rate between the two groups were radiotherapy after breast-conserving surgery, pathological report recording surgical margins, and preoperative cytological or histological diagnosis (P<0.001), and the difference was 86.46%, 30.09% and 20.74%. Multivariate logistic regression analysis showed that: living in a city (OR=2.461, 95%CI: 1.259-4.812), high income (OR=2.580, 95%CI: 1.520-4.380), complications (OR=1.990, 95%CI: 1.104-3.587), pathological stage II (OR=2.511, 95%CI: 1.474-4.278), and patients treated in specialized hospitals (OR=8.407, 95%CI: 4.738-14.917) tended to have higher quality of treatment (P<0.05). Conclusion Hierarchical clustering combined with average utilization rate of evaluation indicators could distinguish patients' treatment quality well. The more use of radiotherapy after breast-conserving surgery, pathological report to record surgical margins and preoperative cytological or histological diagnosis may improve the quality of care better. Doctors should pay more attention to the quality of care for patients living in rural areas, with low income, without complications and in higher pathological stages of tumor.

Key words： breast-conserving surgery quality of care evaluation Jaccard coefficient hierarchical clustering denominator-based weight

Received: 08 October 2021

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	Wei Li
	Wang Chao
	Liu Meina

Cite this article:

Wei Li,Wang Chao,Liu Meina. Quality evaluation of breast conserving surgery patients based on hierarchical clustering and its influence factors[J]. journal1, 2021, 28(5): 395-400.

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http://manu58.magtech.com.cn/Jwk_zgyytj/EN/10.3969/j.issn.1006-5253.2021.05.003 OR http://manu58.magtech.com.cn/Jwk_zgyytj/EN/Y2021/V28/I5/395

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