Applying recursive partitioning to a prospective study of factors associated with adherence to mammography screening guidelines
Applying recursive partitioning to a prospective study of factors associated with adherence to mammography screening guidelines
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DOI：
10.1093/aje/kwi337
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发表时间：
2005-12-15
影响因子：
5
通讯作者：
Jones, BA
中科院分区：
文献类型：
--
作者：
Calvocoressi, L;Stolar, M;Jones, BA
虽然使用传统的统计方法已经确定了一些遵守乳房X光检查筛查指南的预测因素，但许多妇女并没有根据这些指南进行筛查。递归分区可能有助于开发新的干预策略，通过识别不同预测变量的依从性不同的妇女亚组来促进这一筛查行为。在一项对康涅狄格州1229名非裔美国人和白人妇女的前瞻性研究中，从1996-1998年的首次筛查开始，在26个月的随访期内确定了她们对乳房X光检查指南的遵守情况，递归分割从22个候选预测因素中选择了6个，并确定了不同年龄(40-49岁和50-79岁)的预测指标遵守情况不同的子组。在为50-79岁的女性确定的五个亚组中，在随访期间最遵守筛查指南的亚组包括四个预测因素：坚持史、家庭年收入超过15,000美元、相信乳房X光检查非常有用，以及低或中等的乳腺癌易感性。在为40-49岁的女性确定的三个亚组中，最受欢迎的亚组只包括一个预测因素：接受医疗保健提供者的建议进行乳房X光检查。这些发现表明，递归分区可能是一个有用的统计工具，并可能有助于开发干预措施，以促进遵守乳房X光检查筛查指南。
Although a number of predictors of adherence to mammography screening guidelines have been identified using traditional statistical methods, many women are not screening according to these guidelines. Recursive partitioning may aid in developing novel intervention strategies to promote this screening behavior by identifying subgroups of women that differ on adherence across predictor variables. In a prospective study of 1,229 African-American and White women in Connecticut whose adherence to mammography screening guidelines was ascertained over a 26-month follow-up period from initial screening in 1996-1998, recursive partitioning selected six of 22 candidate predictors and identified subgroups that differed on adherence across predictors by age (40-49 and 50-79 years). Among the five subgroups identified for women aged 50-79 years, the subgroup most adherent to screening guidelines during follow-up included four predictors: a history of adherence, annual family income of $15,000 or more, a belief that mammograms were very useful, and low or moderate perceived breast cancer susceptibility. Among the three subgroups identified for women aged 40-49 years, the most adherent subgroup included only one predictor: receipt of a health-care provider's recommendation to obtain a mammogram. These findings suggest that recursive partitioning may be a useful statistical tool and may aid in developing interventions to promote adherence to mammography screening guidelines.