عنوان مقاله :
كاربرد رگرسيون لجستيك تاوانيده در شناسايي اثرات متقابل عوامل خطر فلج مغزي كودكان
عنوان به زبان ديگر :
Application of penalized logistic regression for detecting interactive risk factors in children with Cerebral Palsy
پديد آورندگان :
زارع دلاور، سپيده دانشگاه علوم بهزيستي و توانبخشي تهران - گروه آمار زيستي , بخشي، عنايت اله دانشگاه علوم بهزيستي و توانبخشي تهران - گروه آمار زيستي , سليماني، فرين دانشگاه علوم بهزيستي و توانبخشي تهران - مركز تحقيقات توانبخشي اعصاب اطفال , بيگلريان، اكبر دانشگاه علوم بهزيستي و توانبخشي تهران - گروه آمار زيستي
كليدواژه :
رﮔﺮﺳﯿﻮن ﻟﺠﺴﺘﯿﮏ , ﻓﻠﺞ ﻣﻐﺰي , كودك , ﻋﻮاﻣﻞ ﺧﻄﺮ
چكيده فارسي :
ﺳﺎﺑﻘﻪ و ﻫﺪف: ﺷﻨﺎﺳﺎﯾﯽ ﻋﻮاﻣﻞ ﺧﻄﺮ و اﺛﺮات ﻣﺘﻘﺎﺑﻞ آن ﻫﺎ، در ﻣﻄﺎﻟﻌﺎت ﭘﺰﺷﮑﯽ ﺑﺴﯿﺎر ﻣﻬـﻢ اﺳـﺖ. ﻫـﺪف از اﯾـﻦ ﻣﻄﺎﻟﻌﻪ ﺷﻨﺎﺳﺎﯾﯽ اﺛﺮات ﻣﺘﻘﺎﺑﻞ ﻋﻮاﻣﻞ ﺧﻄﺮ ﻓﻠﺞ ﻣﻐﺰي در ﮐﻮدﮐﺎن 6-1 ﺳﺎﻟﻪ اﺳﺖ. ﻣﻮاد و روش ﻫﺎ: در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﻣﻘﻄﻌﯽ، اﻃﻼﻋﺎت 225 ﮐﻮدك 6-1 ﺳﺎﻟﻪ ﮐﻪ در ﺳﺎل ﻫﺎي 87-1386 ﺟﻤﻊ آوري ﺷـﺪه ﺑﻮد، ﻣﻮرد اﺳﺘﻔﺎده ﻗﺮار ﮔﺮﻓﺖ. ﺑﺮاي ﺷﻨﺎﺳﺎﯾﯽ اﺛﺮات ﻣﺘﻘﺎﺑﻞ از رﮔﺮﺳﯿﻮن ﻟﺠﺴﺘﯿﮏ ﺗﺎواﻧﯿﺪه اﺳﺘﻔﺎده ﺷﺪ. ﺑﺮاي ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿﻞ داده ﻫﺎ از ﻧﺮم اﻓﺰار R ﻧﺴﺨﻪ 2-15-2 اﺳﺘﻔﺎده ﺷﺪ. ﯾﺎﻓﺘﻪ ﻫﺎ: ﻣﺪل رﮔﺮﺳﯿﻮﻧﯽ ﺑﺮﮔﺰﯾﺪه از ﺗﺤﻠﯿﻞ داده ﻫﺎي 89 ﮐﻮدك داراي ﻓﻠﺞ ﻣﻐﺰي و 109 ﮐﻮدك ﺳﺎﻟﻢ ﺑﺎ روش ﮔﺎم ﺑﻪ ﮔﺎم ﭘﯿﺶ رو ﺗﻨﻬﺎ اﺛﺮات اﺻﻠﯽ ﻣﻌﻨـﯽدار-آﺳﻔﯿﮑﺴﯽ (0/001>P)، ازدواج ﻓـﺎﻣ ﯿﻠﯽ واﻟـﺪ ﯾﻦ (0/003=P)، زاﯾﻤـﺎن ﻧـﺎرس (0/002=P)، ﺳﺎﺑﻘﻪ ﺑﯿﻤﺎري (0/001=P) در ارﺗﺒﺎط ﺑﺎ ﻓﻠﺞ ﻣﻐﺰي را ﻧﺸﺎن داد. در ﺣﺎﻟﯽ ﮐﻪ ﺑﺎ روش ﻣﺮﺣﻠﻪ اي ﭘﯿﺶ رو، اﺛﺮات آﺳﻔﯿﮑﺴﯽ )0/001
P) و اﺛﺮات ﻣﺘﻘﺎﺑـﻞ زاﯾﻤـﺎن ﻧـﺎرس: ازدواج ﻓـﺎﻣﯿﻠﯽ (0/040=P)، ﺳﺎﺑﻘﻪ ﺑﯿﻤﺎري: ازدواج ﻓﺎﻣﯿﻠﯽ (0/002=P) ﺷﻨﺎﺳﺎﯾﯽ ﺷﺪﻧﺪ. ﻧﺘﯿﺠﻪ ﮔﯿﺮي: رﮔﺮﺳﯿﻮن ﻟﺠﺴﺘﯿﮏ ﺗﺎواﻧﯿﺪه، ﺑﺮاي ﺷﻨﺎﺳﺎﯾﯽ اﺛﺮات ﻣﺘﻘﺎﺑﻞ ﺑﯿﻦ ﻋﻮاﻣﻞ ﺧﻄﺮﺳﺎز ﺑﯿﻤـﺎريﻫـﺎ، از ﺟﻤﻠـﻪ ﻓﻠﺞ ﻣﻐﺰي، ﭘﯿﺸﻨﻬﺎد ﻣﯽﺷﻮد.
چكيده لاتين :
Introduction: Identification of risk factors and their interactions is important in medical studies. The aim of this study was to identify the interaction of risk factors of cerebral palsy in children with 1-6 years of age. Materials and Methods: In this cross-sectional study the data of 225 children, 1-6 years of age and from 2008 to 2009, were corporate in penalized logistic regression analysis to identify the interactions between the risk factors for cerebral palsy in affected children. Data analysis was performed using the software R version 2.15.2. Results: Selective regression model analyzed the data from 89 children with cerebral palsy and 109 healthy children by using forward step-wise procedure showed the significant difference between the main effects of asphyxia (P<0.001), consanguinity (P=0.003), preterm delivery (P=0.002) and current pregnancy (P=0.001) with cerebral palsy. While using a forward stage-wise procedure of any main effects of asphyxia (P<0.001), consanguinity (P<0.001) and the effects of preterm delivery: consanguinity (P=0.040), current pregnancy: consanguinity (P=0.002) were identified. Conclusion: Penalized logistic regression is suggested to identify interactions between risk factors of disease such as cerebral palsy
