응용통계연구 (The Korean Journal of Applied Statistics)

  • 제31권4호
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  • Pages.529-538
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  • 2018
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  • 1225-066X(pISSN)
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  • 2383-5818(eISSN)
한국통계학회 (The Korean Statistical Society)
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전국 결핵 신환자 의료빅데이터를 이용한 경쟁위험모형 적합

Fitting competing risks models using medical big data from tuberculosis patients

  • 투고 : 2018.06.28
  • 심사 : 2018.07.09
  • 발행 : 2018.08.31
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초록

결핵은 높은 이환과 사망을 일으키는 질병으로 현대의학의 발달에 따라 발생률과 사망률은 감소하고 있다. 그러나 한국은 아직까지 OECD 국가 중 결핵 발생률과 사망률이 가장 높다. 이에 따라 한국은 결핵의 예방 및 통제를 위해 여러 정책 사업을 실시하고 있다. 본 연구에서는 공공민간협력(public-private mix) 결핵관리사업이 치료결과에 미치는 영향을 분석하고 결핵환자의 치료 성공에 영향을 미치는 요인을 확인하고자 한다. 질병관리본부에서 관리하는 결핵환자 신고 자료를 이용하여 2012-2015년 전국 결핵 신환자 코호트 약 13만명을 대상으로 분석하였다. 누적 발생 함수(cumulative incidence function)를 이용하여 요인별로 누적 치료 성공률을 비교하였으며. 주 관심사건(치료성공) 및 경쟁사건(사망)을 고려한 두 가지 경쟁위험모형(cause-specific Cox's proportional hazards model and subdistribution hazard model)을 사용하여 분석 결과를 비교하였다.

Tuberculosis causes high morbidity and mortality. However, Korea still has the highest tuberculosis (TB) incidence and mortality among OECD countries despite decreasing incidence and mortality due to the development of modern medicine. Korea has now implemented various policy projects to prevent and control tuberculosis. This study analyzes the effects of public-private mix (PPM) tuberculosis control program on treatment outcomes and identifies the factors that affecting the success of TB treatment. We analyzed 130,000 new tuberculosis patient cohort from 2012 to 2015 using data of tuberculosis patient reports managed by the Disease Control Headquarters. A cumulative incidence function (CIF) compared the cumulative treatment success rates for each factor. We compared the results of the analysis using two popular types of competition risk models (cause-specific Cox's proportional hazards model and subdistribution hazard model) that account for the main event of interest (treatment success) and competing events (death).

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참고문헌

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