Development of a nomogram for predicting treatment default under facility-based directly observed therapy short-course in a region with a high tuberculosis burden

Abstract

Background: Poor adherence to tuberculosis (TB) treatment is a substantial barrier to global TB control. The aim of this study was to construct a nomogram for predicting the probability of TB treatment default. Methods: A total of 1185 TB patients who had received treatment between 2010 and 2011 in Peru were analyzed in this study. Patient demographics, social, and medical information were recorded. Predictors were selected by least absolute shrinkage and selection operator (LASSO) regression analysis, and a nomogram for predicting TB treatment default was constructed by using multivariable logistic regression analysis. Bootstrapping method was applied for internal validation. Calibration and clinical utility of the nomogram was also evaluated. Results: The incidence of TB treatment default among the study patients was 11.6% (138/1185). Six predictors (secondary education status, alcohol use, illegal drug use, body mass index, multidrug-resistant tuberculosis, and human immunodeficiency virus serostatus) were selected through the LASSO regression analysis. A nomogram was developed based on the six predictors and it yielded an area under the curve (AUC) value of 0.797 [95% confidence interval (CI), 0.755–0.839]. In the internal validation, the AUC achieved 0.805 (95% CI, 0.759–0.844). Additionally, the nomogram was well-calibrated, and it showed clinical utility in decision curve analysis. Conclusion: A nomogram was constructed that incorporates six characteristics of the TB patients, which provides a good reference for predicting TB treatment default.

Estudio Psicométrico De La Escala De Satisfacción Con El Apoyo Social en Personas Con Tuberculosis Pulmonar

“…La tuberculosis, una enfermedad infecciosa cuya forma pulmonar es contagiosa, persiste hoy en día como un problema sanitario a escala mundial 5 . Como requiere un tratamiento considerado largo para su conclusión, las medidas recomendadas para su seguimiento y la identificación de las variables sociales y económicas son fundamentales para su éxito [6][7][8] . Los estudios que pretenden analizar la relación entre los factores psicosociales y la salud deben apoyarse en instrumentos fiables, válidos y adaptados a las poblaciones que pretenden estudiar 9 .…”

Psychometric Study of the Social Support Satisfaction Scale in People With Pulmonary Tuberculosis

“…Tuberculosis, an infectious disease whose pulmonary form is contagious, persists today as a health problem on a global scale 5 . Because it requires a treatment considered long for its completion, the measures recommended for its follow-up and the identification of social and economic variables are fundamental for its success [6][7][8] . Studies that aim to analyze the relationship between psychosocial factors and health should be supported by reliable, valid, and adapted to the populations they intend to study 9 .…”

A model to predict adherence to antiretroviral therapy among people living with HIV

“…Therefore, forecast of the adherence of each PLHIV remains necessary. A recent nomogram model was developed by Wang et al 11 to estimate treatment adherence of patients with tuberculosis in developing areas, with satisfactory performance. Man et al 12 derived a nomogram for predicting the long-term adherence of clozapine therapy using biomarkers.…”