期刊
AMERICAN JOURNAL OF EPIDEMIOLOGY
卷 171, 期 8, 页码 924-931出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwq008
关键词
Africa, antiretroviral therapy; highly active; follow-up studies, HIV, patient dropouts, Zambia
资金
- FIC NIH HHS [K01 TW006670, D43 TW001035, D43-TW001035, K01 TW06670] Funding Source: Medline
- NIAID NIH HHS [P30-AI027767, P30 AI027767] Funding Source: Medline
- PHS HHS [U62/CCU12354] Funding Source: Medline
In many programs providing antiretroviral therapy (ART), clinicians report substantial patient attrition, however, there are no consensus criteria for defining patient loss to follow-up (LTFU) Data on a multisite human immunodeficiency virus (HIV) treatment cohort in Lusaka, Zambia, were used to determine an empirical days-late definition of LTFU among patients on ART. Cohort members were classified as either in care or LTFU as of December 31, 2007, according to a range of days-late intervals. The authors then looked forward in the database to determine which patients actually returned to care at any point over the following year The interval that best minimized LTFU misclassification was described as best-performing. Overall, 33,704 HIV-infected adults on ART were included Nearly one-third (n = 10,196) were at least 1 day late for an appointment The best-performing LTFU definition was 56 days after a missed visit, which had a sensitivity of 84 1% (95% confidence interval (Cl) 83.2, 85.0). specificity of 97.5% (95% Cl 97 3, 97.7), and misclassification of 5 1% (95% Cl 48, 5 3) The 60-day threshold performed similarly well, with only a marginal difference (<0.1%) in misclassification. This analysis suggests that >60 days since the last appointment is a reasonable definition of LTFU Standardization to empirically derived definitions of LTFU will permit more reliable comparisons within and across programs.
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