慢乙肝患者就诊行为模式与疾病进展态势间的关联分析

Analysis of the association between patterns of visit behaviours and disease progression dynamics in patients with chronic diseases: a case of patients with chronic hepatitis B

  • 摘要: 慢性乙型肝炎病毒(HBV)感染会导致不同程度的肝脏损害,患者不良就诊行为模式易导致病情进展,但缺乏基于真实世界数据的探究。对重庆市2007年至2021年七家医院共44 919名慢乙肝患者的就诊数据进行研究,并按照患者既往史,分为患高血压、肝炎、结核、冠心病、糖尿病五种既往史的慢乙肝患者。根据患者的就诊时间序列,利用人类行为动力学中间隔时间分布、阵发性和记忆性三个重要指标来分析患者就诊行为。结果表明,不同既往史的慢乙肝患者人群的就诊行为间隔时间为幂律分布,且具有强阵发性和弱记忆性。患者就诊行为的阵发性与HBV感染相关的不良进展态势有关,即病情越重,阵发性越低。从复杂系统的角度理解患者就诊行为,为进一步探索患者就诊行为模式与疾病不良进展态势之间的关联提供了理论支撑。

     

    Abstract: Chronic hepatitis B virus (HBV) infection leads to varying degrees of liver damage, and poor patient visits behaviour patterns predispose to disease progression, but there is a lack of exploration based on real-world data. The consultation data of a total of 44,919 patients with chronic hepatitis B from seven hospitals in Chongqing from 2007 to 2021 were studied and categorized according to their past histories into five types of chronic hepatitis B patients suffering from hypertension, hepatitis, tuberculosis, coronary artery disease, and diabetes with five types of past histories. According to the time series of patients' visits, three important indicators of human behavioural dynamics, namely interval distribution, burstiness and memory, were used to analyze patients' visit behaviours. The results showed that the intervals of consultation behaviours in the population of chronic hepatitis B patients with different past histories were power-law distributed, and had strong burstiness and weak memory. Burstiness of patient visit behaviour were associated with adverse progression dynamics associated with HBV infection, i.e., the more severe the disease, the lower the burstiness. Understanding patient visit behaviour from the perspective of complex systems provides theoretical support for further exploring the association between patient visit behaviour patterns and adverse disease progression status.

     

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