Lviv clinical bulletin 2021, 1(33)-2(34): 51-64

https://doi.org/10.25040/lkv2021.01-02.051

Risk Factors: Method of Determination and Evaluation, Prognosis in Medicine (Literature Review; Examples of Use in Own Clinical Practice) – first notice

Posted onAuthorAdminЗалишити коментар / Leave a comment

О. Fayura1, А. Маksymuk2, О. Аbrahamovych1, М. Аbrahamovych1, L. Tsyhanyk1, S. Tolopko1, M. Ferko1

1Danylo Halytsky Lviv National Medical University

2Ivan Franko National University of Lviv

Context. Despite the latest advances in modern medicine, the direct etiological factors of many diseases remain unknown or it is impossible to determine the significance of each of them in their occurrence, so the theory of risk factors is extremely relevant for both theoretical and practical medicine. Besides, there often occur situations in which it is necessary to determine the optimal tactics of patient care, because preventive, curative and rehabilitation activities of the doctor require timely prediction of the occurrence probability, further course of the pathological process, its complications, recurrences due to certain environmental factors, threatening and terminal conditions, side effects of drugs. Therefore, the need for a practical solution to these problems has become the basis for the theory of risk factors and prognosis methods.

Objective. To determine the significance of risk factors and methods of their calculation and evaluation, prognosis in medicine, using literature sources, provide specific examples of their use in one’s own clinical practice.

Materials and methods. Content analysis, method of systemic and comparative analysis, bibliosemantic method of studying the current scientific researches concerning the investigation of the importance of risk factors and a technique of their calculation and estimation, prognosis in medicine were used.
The sources were searched for in scientometric databases: PubMed, Medline, Springer, Google Scholar, Research Gate by keywords: risk factors, one-way analysis, multi-factor analysis. 54 literary sources in English and Ukrainian, which highlight the importance of risk factors and methods of their calculation and evaluation, prognosis in medicine were selected and analyzed to describe the results of their use in our own clinical practice.

Results. The concept of risk, as the probability of an adverse event or outcome, is most often used in analytical studies, which are planned to identify the causes and their prevalence of certain conditions. Risk cannot be measured directly by the results of information evaluation in one person, but is calculated on the basis of selective observation of a group of persons who are under the influence (exposed group) of a certain factor. Risk factors are potentially pathogenic factors, in contact with which a person may develop a disease. A full analysis of pathological processes, assessment of risk factors and actual risks are impossible without prognosis, as well as multivariate analysis, which is often based on the probabilistic method of A. Wald or the survival curves construction. In practical health care, cases of medical and social research and in clinical studies, it is often necessary to identify the trends (predict) in changes of a certain condition.

Conclusions. Determining the risk factors, calculating the actual risks and prognosis play an important role in medicine, because in the doctor’s practice there are daily situations that need to determine the optimal tactics taking into account trends, course, severity and results of treatment. Therefore, their definition/calculation must be clear and understandable. Depending on the case, the doctor can use the analysis of the score for certain factors, create risk groups, develop a monitoring plan,  etc. As a result, it becomes possible to create a plan of preventive measures and timely correction of treatment.

References

  1. Wald A. Sequential analysis. Moskow: Fizmagiz; 1960. 307 p. (Russian)
  2. Vorobiev KP. The format of a modern journal publication based on the results of a clinical trial. Part 3. Clinical trial design. Ukrainian Medical Bulletin. 2008;2:150-160 (Russian)
  3. Genkin AA, Gubler EV. The application of sequential statistical analysis for differential diagnosis and the use of this method to distinguish between the two forms of burn disease. Application of mathematical methods in biology and medicine. Leningrad: Leningrad State University Publishing House, 1964;1:174-185 (Russian)
  4. Gerasimenko SS, Golovach AV, Yerina AM. Statistics: Textbook, 2nd ed, rev. і add. K.: KNEU; 2007. 467 p. (Ukrainian)
  5. Gerasimov AN. Medical statistics. Moscow; 2007. 475 p. (Russian)
  6. Golovanova IA, Belikova IV, Lyakhova NO. Fundamentals of Medical Statistics. Textbook for graduate students and clinical residents, Poltava; 2017. 113 p. (Ukrainian)
  7. Holovach AV, Yerina AM, Kozyrev OV. Statistics: Textbook. K.: Higher school; 2008. 623 p. (Ukrainian)
  8. Grigorova AO. Treatment and rehabilitation of injuries and inflammatory diseases of the maxillofacial area, taking into account the psychophysiological condition of patients [dissertation]. Kharkiv: Kharkiv. Nat. Med. University; 2017. 39 p. (Ukrainian)
  9. Gubler EV, Genkin AA. Application of nonparametric criteria for statistics in biomedical research. Leningrad: Medicine; 1973. 140 p. (Russian)
  10. Kovalenko VM. Guidelines for cardiology. K.: Morion, 2009. 1348 p. (Ukrainian)
  11. Konovalov AN, Likhterman LB, Potapov AA. Neurotraumatology. Moskow; 1994. 552 p. (Russian)
  12. Lyzogub VG, Bogdan TV, Sharaeva ML, Kraidashenko OV, Voloshin OO. Side effects of drugs. K.; 2013. 137 p. (Ukrainian)
  13. Lysenko GI, Yashchenko OB. Treatment of patients with arterial hypertension. Ukrainian Medical Bulletin. 2011;3(83):V-VI. Available from: https://www.umj.com.ua/article/13706/medikamentozne-likuvannya-paciyentiv-iz-arterialnoyu-gipertenziyeyu (Ukrainian)
  14. Minzer OP, Voronenko YuV, Vlasov VV. Processing of clinical and experimental data in medicine. Textbook for students of higher educational institutions. K.: Higher School; 2003. 350 p. (Ukrainian)
  15. Moskalenko VF. Biostatistics. Textbook. K.: Knyga Plus; 2009. 184 p. (Ukrainian)
  16. Mocherny SV. Economic Encyclopedia. 3 Vol. Vol. 1. K.: Publishing Center “Academy”; 2000. 864 p. (Ukrainian)
  17. Mulesa O, Syniyuk V, Gerzanich S. The method of fuzzy classification based on Wald’s sequential analysis. Automation of Technological and Business Processes. 2020;11:35-42 (Ukrainian)
  18. Radchenko GD, Mushtenko LO. The course of arterial hypertension depending on the presence of concomitant coronary heart disease. Ukrainian Journal of Cardiology. 2014;2:18-28 (Ukrainian)
  19. Sahanda IV, Negoda TS. Risk factors, structure and dynamics of cardiovascular morbidity of the population of Ukraine. Medicines of Ukraine. 2015;4(25):116-118 (Ukrainian)
  20. Sivolap VD, Kiselyov SM, Lashkul DA. Basic principles of evidence-based medicine: a textbook for candidates for the degree of PhD at the third educational and scientific level in the field of knowledge 22 “Health” specialty 222 “Medicine” discipline “Modern Cardiology”. Zaporizhzhia: ZDMU; 2020. 208 p. (Ukrainian)
  21. Sidorenko OL, Kovbasa NM, Deus’ VYe. Modified risk factors for coronary heart disease in the world. Nursing. 2016;1:27-31 (Ukrainian)
  22. Skakun MP. Fundamentals of evidence-based medicine. Ternopil: Ukrmedknyha; 2005. 244 p. (Ukrainian)
  23. Sklyarov YeYa, Maximets TA. Risk factors and predictors of coronary heart disease in women. Lviv Clinical Bulletin. 2013;4(4):52-55 (Ukrainian) https://doi.org/10.25040/lkv2013.04.052
  24. Smirnova IP, Kvasha OO. Smoking and women’s health. New Medicine. 2005;4(21):14-17 (Ukrainian)
  25. Solonenko I. Fundamentals of epidemiology: Introduction to applied epidemiology and biostatistics. K.: Osnovy; 1997. 501 p. (Ukrainian)
  26. Tereshkin KI. Prognostic and differential diagnostic value of clinical and genealogical risk factors for disorders of the structural and functional state of bone tissue in young people with osteoarthritis on the background of obesity. Actual Problems of Modern Medicine. 2017;17(1):199-204 (Ukrainian)
  27. Tkachenko VI. Analysis of the prevalence and incidence of diabetes among the population of the world and Ukraine for 2003-2013. Medicines of Ukraine. 2014;21(4):55-59 (Ukrainian)
  28. Ulashchyk VS. Choosing a research topic. Health Care. 2014;7:43-49 (Russian)
  29. Tseluiko VY. A course of lectures on clinical cardiology. BME. 1975;21:2004 (Russian)
  30. Sharavara LP, Sevalnev AI. Assessment of aposteriori occupational risk for open-hearth shop workers. Bulletin of Problems of Biology and Medicine. 2017;3(141):91-94 (Ukrainian) https://doi.org/10.29254/2077-4214-2017-4-3-141-91-94
  31. Askari M, Namayandeh SM. The Difference between the Population Attributable Risk (PAR) and the Potentioal Impact Fraction (PIF). Iran J Public Health. 2020;49(10):2018-2019. https://doi.org/10.18502/ijph.v49i10.4713
  32. 3 Azimmatul I. The Use of Cox Regression Model to Analyze the Factors that Influence Consumer Purchase Decision on a Product. Agriculture and Agricultural Science Procedia. 2015;3:78-83. https://doi.org/10.1016/j.aaspro.2015.01.017
  33. Bayes Mr, Price Mr. An Essay towards Solving a Problem in the Doctrine of Chances. By the Late Rev. Mr. Bayes, F. R. S. Communicated by Mr. Price, in a Letter to John Canton, A. M. F. R. S. Philosophical Transactions of the Royal Society of London. 1763;53:370-418. https://doi.org/10.1098/rstl.1763.0053
  34. Brown B, Suesse T, Yap V. Wilson Confidence Intervals for the Two-Sample Log-Odds-Ratio in Stratified 2 × 2 Contingency Tables. Communication in Statistics- Theory and Methods. 2012;41:3355-3370. https://doi.org/10.1080/03610926.2011.560779
  35. Cornfield JA. Method for Estimating Comparative Rates from Clinical Data. Applications to Cancer of the Lung, Breast, and Cervix. J Nat Cancer Institute, 1951;11:1269-1275.
  36. Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ. 2004; 328 (7455):1519. https://doi.org/10.1136/bmj.38142.554479.AE
  37. Glen S. Relative Risk and Absolute Risk: Definition and Examples From Statistics How To. com: Elementary Statistics for the rest of us! https://www.statisticshowto.com/calculate-relative-risk/
  38. Global Health Observatory (GHO) data, Overweight and obesity. Available from: http://www.who.int/gho/ncd/risk_factors/overweight/en/.
  39. Goel MK, Khanna P, Kishore J. Understanding survival analysis: Kaplan-Meier estimate. Int J Ayurveda Res. 2010;1(4):274-278. https://doi.org/10.4103/0974-7788.76794
  40. Grimes DA, Schulz KF. Compared to what? Finding controls for case-control studies. Lancet. 2005;365(9468):1429-1433. https://doi.org/10.1016/S0140-6736(05)66379-9
  41. Heart Disease and Stroke Statistics, American Heart Association. 2015;22:10-15.
  42. Horstkotte D, Follath F, Gutschik E, Lengyel M, Oto A, Pavie A. Guidelines on Prevention, Diagnosis and Treatment of Infective Endocarditis. Executive Summary: The Task Force on Infective Endocarditis of the European Society of Cardiology. EHJ. 2004;25:267-276. https://doi.org/10.1016/j.ehj.2003.11.008
  43. Knol MJ, Algra A, Groenwold RHH: How to Deal with Measures of Association: A Short Guide for the Clinician. Cerebrovasc Dis. 2012;33:98-103. https://doi.org/10.1159/000334180
  44. Kullback S, Leibler RA. On information and sufficiency. Annals of Mathematical Statistics. 1951;22(1):79-86. https://doi.org/10.1214/aoms/1177729694
  45. Kullback S. Information Theory and Statistics. John Wiley & Sons. Republished by Dover Publications in 1968 reprinted in 1978: ISBN 0-8446-5625-9.
  46. Mann CJ. Observational research methods. Research design II: cohort, cross sectional, and case-control studies. Emerg Med J. 2003;20:54-60. https://doi.org/10.1136/emj.20.1.54
  47. Nishimura RA, Carabello BA, Faxon DP, Freed MD, Lytle BW, O’Gara PT et al. ACC/AHA 2008 Guideline update on valvular heart disease: focused update on infective endocarditis: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;52(8):676-685. https://doi.org/10.1016/j.jacc.2008.05.008
  48. Porta M. A Dictionary of Epidemiology (ed. 5th). New York: Oxford University Press; 2008.
  49. Rothman, K. Epidemiology: An Introduction. Oxford, England: Oxford University Press; 2002.
  50. Royston, P, Parmar, MK. Augmenting the logrank test in the design of clinical trials in which non-proportional hazards of the treatment effect may be anticipated. BMC Med Res Methodol. 2016;16:16. https://doi.org/10.1186/s12874-016-0110-x
  51. Schulz KF, Grimes DA. Case-control studies: research in reverse. Lancet. 2002;359(9304):431-434. https://doi.org/10.1016/S0140-6736(02)07605-5
  52. Sullivan L. Essentials of Biostatistics in Public Health. 3rd ed. Publisher: Jones & Bartlett Learning; 2017. 378 p.
  53. Wald A. A Method of Estimating Plane Vulnerability Based on Damage of Survivors. Statistical Research Group, Columbia University. CRC 432 – reprint (1943) from July 1980 Archived 2015-12-10 at the Wayback Machine. Center for Naval Analyses.
  54. Yusuf S, Hawken S, Ounpuu S. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364:937-952. https://doi.org/10.1016/S0140-6736(04)17018-9