Global assessment of leukemia care quality: insights from the quality of care index (QCI) from 1990 to 2021

作者：Yuzhe Pan, Qian Liu, Nan Zhang, Shuang Peng, Xinqi Li, Fuling Zhou · 发表于：EClinicalMedicine · 年份：2024 · DOI：10.1016/j.eclinm.2024.102996 · 被引用次数：34 · 研究领域：Acute Lymphoblastic Leukemia research、Acute Myeloid Leukemia Research、Childhood Cancer Survivors' Quality of Life

Background While advancements in leukemia care have been made, the global quality of care remains a concern. This study utilizes a modified quality of care index (QCI) to assess the global status of leukemia care. Methods We analyzed data from the global burden of disease (GBD) study spanning 1990–2021. The QCI was constructed using principal component analysis, based on the weighted variances of key indicators. We compared the original QCI with our modified version, analyzed QCI trends across different age groups and leukemia subtypes, identified key influencing factors using linear mixed models (LMM), and used spatial autocorrelation analysis to verify the autocorrelation of the socio-demographic index (SDI) region. Then we employed the bayesian age-period-cohort (BAPC) model to predict future QCI trends. Findings Between 1990 and 2021, both the age-standardized incidence rate (ASIR) and age-standardized death rate (ASDR) for leukemia exhibited a consistent decline. Our modified QCI method outperformed the original approach, particularly when the variance explained by the first principal component was below 80%, demonstrating higher correlation with the healthcare access and quality index (HAQI) (Pearson r = 0.91 vs. 0.89) and improved explanatory power (R 2 = 0.82 vs. 0.79). Over past three decades, QCI was highest in San Marino (97.72%) and lowest in Fiji (3.51%), with significant regional variations across SDI levels ( F = 133.40, p < 2e-16). High-SDI regions had the hig...