期刊
JOURNAL OF CLINICAL EPIDEMIOLOGY
卷 66, 期 9, 页码 1006-1013出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jclinepi.2013.03.013
关键词
Antiretroviral therapy; Program outcomes; Loss to follow-up; Cohort; Retention; Survival analysis
资金
- National Institutes of Health (National Institute of Allergy and Infectious Diseases, National Institute of Child Health and Human Development, National Cancer Institute) [5U01AI069924-06]
- Canadian Institutes of Health Research
- South African Center of Excellence in Epidemiological Modeling and Analysis
- Elizabeth Glaser Pediatric Foundation
- South African Centre of Excellence in Epidemiological Modeling and Analysis
Objective: To examine the impact of different definitions of loss to follow-up (LTFU) on estimates of program outcomes in cohort studies of patients on antiretroviral therapy (ART). Study Design and Setting: We examined the impact of different definitions of LTFU using data from the International Epidemiological Databases to Evaluate AIDS Southern Africa. The reference approach, Definition A, was compared with five alternative scenarios that differed in eligibility for analysis and the date assigned to the LTFU outcome. Kaplan-Meier estimates of LTFU were calculated up to 2 years after starting ART. Results: Estimated cumulative LTFU were 14% and 22% at 12 and 24 months, respectively, using the reference approach. Differences in the proportion LTFU were reported in the alternative scenarios with 12-month estimates of LTFU varying by up to 39% compared with Definition A. Differences were largest when the date assigned to the LTFU outcome was 6 months after the date of last contact and when the site-specific definition of LTFU was used. Conclusion: Variation in the definitions of LTFU within cohort analyses can have an appreciable impact on estimated proportions of LTFU over 2 years of follow-up. Use of a standardized definition of LTFU is needed to accurately measure program effectiveness and comparability between programs. (C) 2013 Elsevier Inc. All rights reserved.
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