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2024 Vol. 31, No. 1
Published: 2024-02-25
1
Mindfulness levels in chronic HBV infected patients based on a latent profile analysis approach
Gong Shuping，Yu Nannan，Hou Xuna，Chen Xingru，Sun Lei，Zhao Xiaomin
DOI: 10.3969/j.issn.1006-5253.2024.01.001
Guide::
Objective
To explore the latent profiles of mindfulness levels among chronic HBV infected patients, and to analyze the population characteristics and influencing factors of different profiles.
Methods
From April 2020 to January 2021, chronic HBV infected patients from an infectious disease hospital in Shandong Province were selected by successive sampling method and investigated using a general information questionnaire, the Mindful Attention Awareness Scale and the Social Support Rating Scale. The latent profiles were analyzed using the Mindful Attention Awareness Scale score as an exogenous indicator, and the influencing factors of different profiles of mindfulness were explored by univariate analysis and binary logistic regression.
Results
Positive thinking level of chronic HBV-infected patients could be categorized into low positive thinking level group (39.68%) and medium-high positive thinking level group (60.32%). Univariate analysis of variance showed that gender, self-assessment of health status, satisfaction with support, severity of discrimination, and social support (objective support, subjective support, and utilization of support) were predictive of the 2 potential categories of positivity level in chronically HBV-infected patients with statistically significant differences (P<0.05). Binary logistic regression showed that gender (OR=0.499, P=0.017), self-assessment of health status (OR=1.789, P=0.001), severity of discrimination (OR=0.718, P=0.025), and subjective support (OR=1.066, P=0.016) would have an effect on the latent profiles of the level of positive thinking among people with chronic HBV infection.
Conclusion
Heterogeneity exists in the level of mindfulness among chronic HBV infected patients, and healthcare workers can identify population characteristics and influencing factors of different profiles by categorizing chronic HBV infected patients to provide more precise intervention programs to improve their mindfulness level.
2024 Vol. 31 (1): 1-6 [
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Prediction of the number of brucellosis cases in China based on prophet model
Wen Fudong，Zhao Binyu，Su Yue，Wang Yupeng
DOI: 10.3969/j.issn.1006-5253.2024.01.002
Guide::
Objective
To establish a time series model suitable for predicting the number of cases of brucellosis in China, and provide a scientific basis for preventing and controlling this disease.
Methods
This study utilized data on the number of cases from January 2015 to December 2021 to establish SARIMA and prophet models, respectively. Subsequently, the predictive performance of these two models was validated by using data from January 2022 to April 2023, and the results of the model predictions were compared by using three indicators: RMSE, MAPE, and MAE. Finally, the prophet model with higher accuracy was used to predict the number of cases from May 2023 to April 2024.
Results
The overall number of cases of brucellosis in China is rising, reaching its peak from June to July each year, showing a clear seasonal trend. Compared to the SARIMA model, the RMSE, MAPE, and MAE values of the prophet model are lower, indicating that the prophet model has higher accuracy in predicting brucellosis. The predicted peak of the number of cases in 2023 is lower than the actual peak in 2021 and 2022.
Conclusion
The prophet model can better fit the monthly reported number of cases of brucellosis in the country and can be used for short-term prediction.
2024 Vol. 31 (1): 7-10 [
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11
Construction of interpretable prediction model for lower limb deep vein thrombosis in patients undergoing total hip arthroplasty based on machine learning and SHAP
Xu Qing，Yu Bing，Zhou Peimin，Dai Shenjie，Dong Xiaomin
DOI: 10.3969/j.issn.1006-5253.2024.01.003
Guide::
Objective
To construct a machine learning model to predict the risk of deep venous thrombosis (DVT) in patients undergoing total hip arthroplasty (THA), and to identify key risk factors influencing DVT using shapley additive explanations (SHAP) method.
Methods
We retrospectively analyzed data from 416 patients who underwent THA in Wenzhou People′s Hospital from January 1, 2017 to July 31, 2022, and randomly divided them into a training set and a test set in a 4∶〖KG-*2/3〗1 ratio. Recursive feature elimination and five-fold cross-validation were used to select the best features. Six machine learning algorithms were utilized to develop predictive models, and various performance metrics were employed to evaluate them. The SHAP method was used to analyze the interpretability of the optimal model.
Results
Four hundred and sixteen patients were included in the final study, including 333 in the training set and 83 in the test set. The XGBoost model was the most accurate on the test dataset, achieving a sensitivity of 0.817, specificity of 0.783, F1 score of 0.860, ROC-AUC of 0.800, and a Brier score of 0.106. SHAP summary plots showed that age, cholesterol, postoperative bed time, fibrinogen, and preoperative plasma D-dimer levels were the top five determinants for post-THA DVT. SHAP values feature dependence plots revealed complex non-linear effects of these factors on DVT risk, with age, bed rest, and fibrinogen showing an inverted U-shaped relationship, and cholesterol displaying a positive correlation. Individual SHAP values offered insights into each predictor′s role in DVT risk.
Conclusion
This study developed an efficient and interpretable machine learning model to predict DVT risk in THA patients, which is helpful for clinical health professionals in identifying high-risk patients and providing personalized intervention.
2024 Vol. 31 (1): 11-18 [
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Establishment of nomogram model for individualized prediction of risk of acute left heart failure in elderly patients with chronic renal failure
Shen Yujuan
DOI: 10.3969/j.issn.1006-5253.2024.01.004
Guide::
Objective
To construct a nomogram model for predicting the risk of acute left heart failure in elderly patients with chronic renal failure.
Methods
Two hundred and ninety-four elderly patients with chronic renal failure admitted to our hospital from January 2019 to December 2019 were selected as the study subjects. According to the occurrence of acute left heart failure, they were divided into the left heart failure group (n=61) and the control group (n=233). The clinical data of the patients were collected. The risk factors of acute left heart failure in elderly patients with chronic renal failure were analyzed by univariate and multivariate logistic regression, and a nomogram model was established.
Results
Age≥70 years old, diabetes, poor blood pressure control, blood phosphorus concentration≥1.61 mmol/L, hemoglobin<60g/L and pulmonary infection were independent risk factors of acute left heart failure in elderly patients with chronic renal failure (P<0.05). The model validation results showed that the C-index was 0.745, the calibration curve was close to the ideal curve, and the AUC of the ROC curve was 0.751 (95%CI: 0.711-0.791). Within the range of 10%84%, the nomogram had a net benefit.
Conclusion
Age≥70 years old, diabetes, poor blood pressure control, blood phosphorus concentration≥ 1.61mmol/L, hemoglobin<60g/L and pulmonary infection will increase the risk of acute left heart failure in elderly patients with chronic renal failure. The nomogram model established in this study has a good predictive effect on acute left heart failure in elderly patients with chronic renal failure.
2024 Vol. 31 (1): 19-24 [
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25
Analysis of nutrition and health knowledge of adult residents in Wuning County, Jiangxi Province in 2022 and its influencing factors
Liu Yanming，Wang Chunyang，Liang Xiaobao，Wang Yating， Wang Qi，Hu Zhiyong，Wei Fei
DOI: 10.3969/j.issn.1006-5253.2024.01.005
Guide::
Objective
To understand the level of nutrition and health knowledge of adult residents in Wuning County, Jiangxi Province under the background of healthy China, analyze the existing shortcomings of nutrition and health knowledge, and discuss the relevant influencing factors of residents′ nutrition and health knowledge awareness, so as to provide a scientific basis for the formulation of nutrition intervention policies.
Methods
A total of 895 local residents aged 18-64 years old in Wuning County, Jiangxi Province were selected to carry out a questionnaire survey on nutrition and health knowledge, the awareness rate was calculated, the acquisition channels of nutrition knowledge were analyzed and compared, and the main factors affecting the awareness rate of nutrition and health knowledge were analyzed by variance analysis and multivariate logistic regression method.
Results
The average age of 895 respondents was 39.49±12.08 years old, and males accounted for 51.62%. The awareness rate of high-oil and high-salt food was the highest (85.59%), followed by the best calcium supplement food (55.75%), and the daily salt intake of healthy adults (41.68%). The average score of nutrition knowledge was 11.01±2.38 points. The most extensive way for respondents to obtain nutrition knowledge was WeChat /Weibo /Tiktok /Kuaishou, accounting for 91.28% of the total number of respondents. There were statistically significant differences in the average scores and awareness rates of different age groups (F=30.80, P<0.001), different education level groups (F=22.26, P<0.001), different occupational groups (F=20.06, P<0.001), and different health status groups (F=5.34, P=0.005). Logistics regression analysis showed that education level and occupation type were the influencing factors of nutrition knowledge score (P<0.05).
Conclusion
The awareness rate of nutrition and health knowledge among adult residents in Wuning County, Jiangxi Province is related to age, occupation, education level and health status, and it is necessary to focus on the weak links and take corresponding measures according to the characteristics of different groups of people, and strengthen the dissemination of health and nutrition knowledge through multiple channels.
2024 Vol. 31 (1): 25-29 [
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25
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Status quo of knowledge, attitude, belief and practice of ophthalmic nurses with concept of enhanced recovery after surgery and its influencing factors
Li Ping，Qi Shanshan，Zhou Mangmang
DOI: 10.3969/j.issn.1006-5253.2024.01.006
Guide::
Objective
To explore the status quo of knowledge, attitude, belief and practice (KABP) among ophthalmic nurses with enhanced recovery after surgery (ERAS) and its influencing factors.
Methods
The convenient sampling method was used to select 168 cases of ophthalmic nurses from 4 hospitals in Wenzhou from January 2020 to December 2021 as the survey objects. The self-made ERAS KABP scale was used to investigate the status of nurses′ ERAS KABP. The status quo of ERAS KABP of ophthalmic nurses was analyzed. Multiple linear regression analysis was used to analyze the influencing factors of ERAS in ophthalmic nurses.
Results
The score of knowledge in ERAS of 168 ophthalmic nurses was (37.34±9.49), the score of attitude was (33.74±8.67) , the score of practice was (26.52±6.55), and the total score was (97.60±22.98). The results of univariate analysis showed that there were statistically significant differences in ERAS scores among ophthalmic nurses with different ages, working years, educational levels, professional titles, hospital levels, department categories and employment forms (P<0.05). Multiple linear regression analysis showed that department categories, hospital levels, working years and professional titles were the influencing factors of ERAS of ophthalmic nurses (P<0.05).
Conclusion
The status of ERAS in ophthalmic nurses in Wenzhou is at a medium level on the whole, which is easily affected by department categories, hospital levels, working years and professional titles and other factors. Hospitals should provide professional training on ERAS for nurses regularly to improve the overall level of ERAS in ophthalmic nurses.
2024 Vol. 31 (1): 30-34 [
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Epidemiological characteristics and trend prediction of pulmonary tuberculosis from 2012 to 2022 in Yantai
Zhu Sijin，Sun Cong，Chu Tianci，Jin Xiaoxiang，Shao Xiao，Wang Yuelei，Hu Naibao
DOI: 10.3969/j.issn.1006-5253.2024.01.007
Guide::
Objective
To analyze the epidemiological characteristics of tuberculosis and predict the trend of tuberculosis incidence.
Methods
The tuberculosis incidence data of Yantai City from 2012 to 2022 were collected and sorted out from the Tuberculosis Management Information System of the China Disease Control and Prevention Information System, and the epidemiological characteristics of tuberculosis were analyzed; the data from 2012 to 2021 were used to establish an optimal model, the data of 2022 were used to test the model and predict the incidence of tuberculosis from 2023-2025.
Results
The incidence of tuberculosis in Yantai showed an overall decreasing trend from 2012 to 2022 (P<0.001); the number of incidence cases was less in January, February and October each year, and more from March to May. Longkou City had the highest incidence rate (32.79/100 000) and Fushan District had the lowest (9.28/100 000) in different districts and cities. In population distribution, the incidence rate of males was 2.86 times that of females, and the highest proportion of incidence was found in people aged 20 to under 40 years old, followed by people aged ≥60 years old; farmers were the main incidence group in occupational distribution. After modeling and fitting, ARIMA(0,1,1)(0,1,1)12 was derived as the optimal model, and the model test results showed that the average relative error between the actual value and the predicted value from January to December 2022 was 15.07%, and the predicted number of monthly incidence of tuberculosis in Yantai City from 2023 to 2025 was 57-103, 48-94, and 39-85 respectively.
Conclusion
The incidence of tuberculosis in different districts and cities of Yantai City varies, and men, farmers, young adults and the elderly are the key populations for the prevention and control of tuberculosis; it is predicted that the incidence of tuberculosis in Yantai City will show a decreasing trend from 2023 to 2025, which can be used as a reference for the relevant departments in the prevention and control of tuberculosis.
2024 Vol. 31 (1): 35-40 [
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41
Epidemiological characteristics of statutory infectious diseases in Tongxiang City from 2013 to 2022
Wang Guohua，Liu Jian
DOI: 10.3969/j.issn.1006-5253.2024.01.008
Guide::
Objective
To analyze the epidemiological characteristics of statutory infectious diseases in Tongxiang City and provide scientific basis for the development of effective prevention and control measures.
Methods
Descriptive epidemiological methods were used to analyze the data on the incidence of statutory infectious diseases reported in Tongxiang Ctity from 2013 to 2022.
Results
There were no reports of class A infectious diseases in the city. There were 47 944 cases of statutory infectious diseases reported, with an average annual incidence rate of 546.69 per 100 000. There were 43 reported deaths, with an average annual mortality rate of 0.49 per 100 000. The top five diseases in terms of incidence were other infectious diarrheal diseases, hand, foot and mouth disease, gonorrhea, syphilis, and tuberculosis, accounting for 86.64% of all reported cases of infectious diseases. The spatial distribution of outbreaks conformed to the characteristics of infectious diseases. The composition ratio of transmission route from high to low was as follows: intestinal infectious diseases accounted for 61.03%, bloodborne and sexually transmitted infectious diseases accounted for 23.11%, respiratory tract infectious diseases accounted for 15.41%, natural foci and vectorborne infectious diseases accounted for 0.39%, and other routes accounted for 0.06%. The incidence of other infectious diarrheal diseases and hand, foot and mouth disease were the highest in the low age group (0＜15 years old).
Conclusion
Attention should be paid to the prevention and control of intestinal and respiratory tract infectious diseases such as other infectious diarrheal diseases, hand, foot and mouth disease, and influenza in densely populated collective units such as childcare institutions and schools. Adults should be aware of sexually transmitted diseases such as gonorrhea, syphilis, and intestinal infectious diseases such as other infectious diarrheal diseases. Strengthening health education and promoting disease prevention awareness can help reduce the incidence of infectious diseases.
2024 Vol. 31 (1): 41-46 [
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47
Application of cumulative ratio logit model and partial proportional odds model in analyzing factors influencing hospitalization costs for lung cancer surgery patients
Zeng Xiangman
DOI: 10.3969/j.issn.1006-5253.2024.01.009
Guide::
Objective
To illuminate the application of cumulative odds logit model and partial proportional odds model in ordinal categorical data.
Methods
The cumulative odds logit model and partial proportional odds model were used to fit the relationship between hospital costs and relative factors of lung cancer surgery. The goodness of fit of the two models was compared by the log likelihood value (-2ln L) of the models.
Results
When the independent variables did not fully satisfy the proportional odds assumption (gender χ2=15.888, P＜0.001; surgical procedure χ2=35.874，P＜0.001), the fitting results of the two methods were different. At different segmentation points, there was a significant difference in the relationship between hospitalization costs and surgical procedures. The partial proportional odds model (-2ln L=5 797.112) was better than the cumulative odds logit model (-2ln L=5 852.420). The difference of the log likelihood values was statistically significant (P<0.05).
Conclusion
In order to analyze the ordinal categorical data, the proportional odds assumption should be verified firstly. If all the independent variables satisfy the condition, the cumulative odds logit model is selected, otherwise the partial proportional odds model is used to study the data.
2024 Vol. 31 (1): 47-49 [
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Characteristics of pediatric inpatients in a tertiary hospital in Anhui Province from 2018 to 2022
Zhang Panpan，Chen Lei，Gao Bo
DOI: 10.3969/j.issn.1006-5253.2024.01.010
Guide::
Objective
To analyze the disease distribution of pediatric inpatients in a tertiary hospital in the past five years, and to provide basis for the dynamic allocation of pediatric medical resources and the development of the discipline.
Methods
According to the National Clinical Edition 2.0 diagnosis code (ICD-10) , the diseases were classified, and the hospitalized pediatric patients from 2018 to 2022 were taken as the original data. Excel 16.0 and SPSS 26.0 statistical analysis software were used to analyze gender, age, seasonal distribution and disease composition of hospitalized children retrospectively.
Results
From 2018 to 2022, a total of 35 714 pediatric patients were admitted, with a male to female ratio of 1.51∶〖KG-*2/3〗1. There was a gender difference in the distribution of hospitalized children (χ2=20.472，P<0.001) . On the whole, the infants were the most (42.26%) , but the proportion of hospitalized infants was decreasing year by year, and the proportion of hospitalized infants in winter was the highest (30.57%) , followed by summer (24.04%) , spring (23.27%) and autumn (22.12%). The first five kinds of diseases were respiratory system diseases (51.21%) , some diseases originated from perinatal period (15.75%) , some infectious diseases and parasitic diseases (11.81%) , gastrointestinal disease diseases (8.87%) and neurological disorder diseases (4.36%). There were annual and seasonal differences in the order of the first five diseases (P<0.001). Respiratory diseases, conditions originating in the perinatal period, and gastrointestinal disease in winter all accounted for the highest proportion.
Conclusion
The hospital should dynamically adjust the allocation of pediatric medical resources according to the seasonal changes, and improve the diagnosis and treatment techniques and nursing level of common and frequently-occurring diseases in children of different genders and ages, to strengthen the management of key pediatric diseases and discipline construction.
2024 Vol. 31 (1): 50-55 [
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Visual analysis of teaching model of Medical Statistics from 2000 to 2022
Wang Fenglin，Kong Yujia，Wang Qinghua，Li Yanli，Shi Fuyan，Wang Suzhen
DOI: 10.3969/j.issn.1006-5253.2024.01.011
Guide::
Objective
To analyze the research hotspots and development trends of the teaching model of Medical Statistics.
Methods
NoteExpress software was used to modify and integrate the 569 valid literatures related to the teaching model of Medical Statistics into a form that could be recognized by CiteSpace software, and then CiteSpace 6.1.R2 software was used for visual analysis, including the growth trend of related literatures, high-yield institutions, core authors, high-frequency keywords, keyword clustering, emerging words, etc.
Results
The number of publications related to the teaching model of Medical Statistics showed an overall upward trend. There was almost no academic cooperation among institutions in this research field. The top three authors published 26, 23 and 12 papers respectively. A total of 378 nodes and 912 connections were identified in the network map, and the network density was 0.013, and the top 3 keywords were "teaching reform" with 129 times, "teaching methods" with 53 times, and "teaching" with 50 times. The keywords were clustered into 11 classes, of which the module value was 0.623 and the average outline value was 0.858. A total of 19 emergent words were identified, among which the top 3 keywords for emergent intensity were "teaching methods", "flipped classroom" and "medical statistics".
Conclusion
At present, scholars′ research on the teaching model of Medical Statistics is in a period of stable development. There is little academic cooperation among institutions in this field, but there is close cooperation between prolific scholars. Research hot topics include teaching reform, teaching methods, teaching, teaching effects, and teaching modes. Medical schools are the main research trend of the teaching reform model of Medical Statistics.
2024 Vol. 31 (1): 56-60 [
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Research on simulated case teaching in the course of Medical Multiple Statistical Methods
Wang Yaru，Wang Jiu，Liu Haixia，Hou Jing，Zhang Li，Li Zhi，Sun Hongwei
DOI: 10.3969/j.issn.1006-5253.2024.01.012
Guide::
Objective
The complexity of the concept of multivariate statistics can easily lead to difficulties in students′ understanding. This article uses simulation experiments to examine the impact of various characteristics of data on the analysis results, in order to strengthen students′ understanding of the principles of multivariate statistics and facilitate their correct application of multivariate statistical methods.
Methods
Six simulation experiments were designed, and R 4.2.2 was used to generate simulation data and conduct statistical analysis to explore the impact of data characteristics on the 6 statistical analysis methods.
Results
According to the statistical analysis results of simulation experiments, the multicollinearity among independent variables in multilinear regression will make the regression coefficient estimation of the regression equation inaccurate. The correlation structure between variables in principal component and factor analysis affects the dimensionality reduction effect. In logistic regression, the nonlinear influence of independent variables on dependent variables should be considered, otherwise the results will affect the accuracy of the estimation results. When the proportion of deletion in Cox regression is too large, especially after reaching 60%, the results of the Cox regression model have a significant deviation. The correlation structure between variables affects the results of canonical correlation analysis. When there is a large difference in the proportion of categories, Bayesian discrimination and logistic regression are more appropriate for discrimination, because Bayesian discrimination with prior probability is more flexible.
Conclusion
The application of multivariate statistical methods needs to fully consider applicable conditions such as data characteristics. Through simulation experiments, students are encouraged to independently run simulation experiments, intuitively understand abstract multivariate concepts, and facilitate the understanding and application of multivariate statistical methods.
2024 Vol. 31 (1): 61-66 [
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Implementation and application of quality control system for medical record homepage data based on VB 6.0
DOI: 10.3969/j.issn.1006-5253.2024.01.013
Guide::
Objective
To develop a quality control system for medical record homepage data based on VB6.0 programming software to improve the quality of medical record homepage data.
Methods
The data quality control system of the first page of medical records was constructed by calling four stored procedures of the SQL Server database: provincial rules, dictionary rules, data logic rules and hospital rules.
Results
After the implementation and application of the system, according to the monthly rating feedback of the homepage data quality evaluation system, the monthly average number of violations of the verification rule was 3.29 from October 2019 to July 2022, and decreased to 0.23 from August 2022 to August 2023; the full score rate of medical record homepage quality increased from 17.65% to 84.62%, with a significant improvement; the full score rate of medical record quality and the full score rate of verification rules reached 100.00% and 84.62% respectively, and the full score rate was also significantly improved.
Conclusion
Currently, many hospitals are limited by factors such as low level of hospital informationization, inadequate knowledge of doctors regarding relevant medical records, and poor collaboration between hospital information and medical record personnel. This method can be used to assist hospital medical record personnel in improving the quality of medical record data.
2024 Vol. 31 (1): 67-71 [
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Analysis and visualization of performance evaluation indicators on the homepage of medical records in tertiary public hospitals based on Power BI
Liang Biyu，Zhang Yuqiong，Chen Junying，He Weiming
DOI: 10.3969/j.issn.1006-5253.2024.01.014
Guide::
Objective
To explore a data statistical analysis and visualization display method based on Power BI under the background of performance evaluation in tertiary public hospitals, so as to improve the efficiency of hospital statisticians′ data statistics and analysis; to promote the efficiency and quality of medical management by using visualization, to assist in daily indicator monitoring, and to assist management and decision-making.
Methods
The first page data of medical records were extracted from a tertiary public hospital from January 1, 2022 to June 30, 2023 to establish a power BI based first page index data query system for performance evaluation of tertiary public hospitals based on the statistical caliber of the first page index data of medical records for performance evaluation of tertiary public hospitals, for data analysis and visual display.
Results
The performance evaluation medical record homepage indicator data query system for tertiary public hospitals based on Power BI can quickly query multi-dimensional and multi scenario indicator data, which is practical and easy to operate.
Conclusion
Power BI can be used as a tool for hospital statistical staff to conduct data analysis and visual display, which is worth promoting and using. Hospital statistical staff can combine this study to apply Power BI to practical work, improve work efficiency, and assist daily statistical work.
2024 Vol. 31 (1): 72-76 [
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Policy requirements and evaluation system of detailed management on medical consumables
Xue Yunlian，Liu Guihao
DOI: 10.3969/j.issn.1006-5253.2024.01.015
Guide::
In recent years, China has put forward a series of policies on controlling medical consumables. In order to improve the level of detailed management of consumables, medical institutions have carried out a series of studies based on the datadriven evaluation index system of refined management of consumables. This study systematically reviews the policy requirements of consumable control in China since 2009, and studies the evaluation index system of consumables from the perspectives of consumable access and consumable use, and discusses some problems that exist objectively and need to be avoided in the construction of index system. We hope to provide ideas of refinement control of consumables in medical institutions.
2024 Vol. 31 (1): 77-80 [
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