Your browser doesn't support javascript.
loading
An empirical approach to defining loss to follow-up among patients enrolled in antiretroviral treatment programs.
Chi, Benjamin H; Cantrell, Ronald A; Mwango, Albert; Westfall, Andrew O; Mutale, Wilbroad; Limbada, Mohammed; Mulenga, Lloyd B; Vermund, Sten H; Stringer, Jeffrey S A.
Afiliação
  • Chi BH; Centre for Infectious Disease Research in Zambia, Box 34681, 1275 Lubuto Road, Lusaka, Zambia. bchi@cidrz.org
Am J Epidemiol ; 171(8): 924-31, 2010 Apr 15.
Article em En | MEDLINE | ID: mdl-20219765
ABSTRACT
In many programs providing antiretroviral therapy (ART), clinicians report substantial patient attrition; however, there are no consensus criteria for defining patient loss to follow-up (LTFU). Data on a multisite human immunodeficiency virus (HIV) treatment cohort in Lusaka, Zambia, were used to determine an empirical "days-late" definition of LTFU among patients on ART. Cohort members were classified as either "in care" or LTFU as of December 31, 2007, according to a range of days-late intervals. The authors then looked forward in the database to determine which patients actually returned to care at any point over the following year. The interval that best minimized LTFU misclassification was described as "best-performing." Overall, 33,704 HIV-infected adults on ART were included. Nearly one-third (n = 10,196) were at least 1 day late for an appointment. The best-performing LTFU definition was 56 days after a missed visit, which had a sensitivity of 84.1% (95% confidence interval (CI) 83.2, 85.0), specificity of 97.5% (95% CI 97.3, 97.7), and misclassification of 5.1% (95% CI 4.8, 5.3). The 60-day threshold performed similarly well, with only a marginal difference (<0.1%) in misclassification. This analysis suggests that > or =60 days since the last appointment is a reasonable definition of LTFU. Standardization to empirically derived definitions of LTFU will permit more reliable comparisons within and across programs.
Assuntos

Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 1_ASSA2030 Base de dados: MEDLINE Assunto principal: Pacientes Desistentes do Tratamento / Infecções por HIV / Interpretação Estatística de Dados / Fármacos Anti-HIV Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Humans País/Região como assunto: Africa Idioma: En Revista: Am J Epidemiol Ano de publicação: 2010 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 1_ASSA2030 Base de dados: MEDLINE Assunto principal: Pacientes Desistentes do Tratamento / Infecções por HIV / Interpretação Estatística de Dados / Fármacos Anti-HIV Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Humans País/Região como assunto: Africa Idioma: En Revista: Am J Epidemiol Ano de publicação: 2010 Tipo de documento: Article