抽象的
Nontuberculous mycobacterial lung disease (NTMLD) is a rare lung disease often missed due to a low index of suspicion and unspecific clinical presentation. This retrospective study was designed to characterise the pre-diagnosis features of NTMLD patients in primary care and to assess the feasibility of using machine learning (ML) to identify undiagnosed NTMLD patients.
IQVIA医学研究数据(IMRD;融合了CEGEDIM数据库),使用了英国电子病历初级保健数据库。在2003年至2017年之间,通过初级或二级护理或NTMLD治疗方案的记录确定了NTMLD患者。在文献和专家临床意见的指导下,在诊断前时期提取了危险因素和治疗。对照人群富含这些功能中的至少一个。
总共选择了741个NTMLD和112 784例对照患者。NTMLD的年度患病率从2006年到2016年,从2.7倍增加到每100000。NTMLD患者最常见的先前诊断和治疗方法是慢性阻塞性肺部疾病,哮喘,青霉素,大环内酯类药物,大环内酯类药物和吸入性皮质类固醇。与随机测试相比,ML将NTMLD患者的检测提高了近一千倍,AUC为0.94。2016年,诊断为NTMLD的诊断和未诊断病例的总患病率估计在每10万次范围内9至16之间。
这项研究支持将ML应用于初级保健数据的可行性,以筛选未诊断的NTMLD患者,结果表明在英国可能存在大量未诊断的NTMLD病例。
脚注
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Conflict of interest: Dr. Doyle reports other from Insmed, during the conduct of the study; and is employed by IQVIA.
Conflict of interest: Dr. van der Laan reports other from Insmed, during the conduct of the study; and is employed by Insmed.
Conflict of interest: Dr. Obradovic reports other from Insmed, during the conduct of the study; and is employed by Insmed.
Conflict of interest: Dr. McMahon reports other from Insmed, during the conduct of the study; and is employed by IQVIA.
Conflict of interest: Dr. Daniels reports other from Insmed, during the conduct of the study; and is employed by IQVIA.
Conflict of interest: Dr. Pitcher reports other from Insmed, during the conduct of the study; and is employed by IQVIA.
Conflict of interest: Dr. Loebinger reports personal fees and other from Insmed, during the conduct of the study; personal fees from Savara, personal fees from Grifols, personal fees from Bayer, personal fees from Astra Zeneca, personal fees from Polyphor, personal fees from Meiji, outside the submitted work.
- 已收到2020年1月9日。
- Accepted2020年4月22日。
- 复制right ©ERS 2020