Sampling-Based Approaches to Improve Estimation of Mortality among Patient Dropouts Experience from a Large PEPFAR-Funded Program in Western Kenya 英文参考文献.docVIP

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Sampling-Based Approaches to Improve Estimation of Mortality among Patient Dropouts Experience from a Large PEPFAR-Funded Program in Western Kenya 英文参考文献.doc

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Sampling-Based Approaches to Improve Estimation of Mortality among Patient Dropouts Experience from a Large PEPFAR-Funded Program in Western Kenya 英文参考文献

Sampling-BasedApproachestoImproveEstimationof MortalityamongPatientDropouts:Experiencefroma LargePEPFAR-FundedPrograminWesternKenya ConstantinT.Yiannoutsos1*,Ming-WenAn2,ConstantineE.Frangakis3,BeverlyS.Musick1 ,Paula Braitstein4,6,9,KaraWools-Kaloustian5,6,DanielOchieng6,JeffreyN.Martin7,MelanieC.Bacon8 ,Vincent Ochieng6,SylvesterKimaiyo6,9 1Indiana University Division of Biostatistics, Indianapolis, Indiana, United States of America, 2Department of Mathematics, Vassar College, Poughkeepsie, New York, UnitedStatesofAmerica,3DepartmentofBiostatistics,JohnsHopkinsUniversity,Baltimore,Maryland,UnitedStatesofAmerica,4IndianaUniversityDivisionofGeneral InternalMedicineandGeriatrics,Indianapolis,Indiana,UnitedStatesofAmerica,5IndianaUniversityDivisionofInfectiousDiseases,Indianapolis,Indiana,UnitedStatesof America, 6Academic Model for the Prevention and Treatment of HIV/AIDS (AMPATH), Eldoret, Kenya, 7Department of Epidemiology and Biostatistics, University of CaliforniaSanFrancisco,SanFrancisco,California,UnitedStatesofAmerica,8NationalInstituteofAllergiesandInfectiousDiseases(NIAID),Bethesda,Maryland,United StatesofAmerica,9MoiUniversity,SchoolofMedicine,Eldoret,Kenya Abstract Background: Monitoring and evaluation (ME) of HIV care and treatment programs is impacted by losses to follow-up (LTFU)inthepatientpopulation.Theseverityofthiseffectisundeniablebutitsextentunknown.Tracingalllostpatients addressesthisbutcensusmethodsarenotfeasibleinprogramsinvolvingrapidscale-upofHIVtreatmentinthedeveloping world. Sampling-based approaches and statistical adjustment are the only scaleable methods permitting accurate estimationofMEindices. Methodology/PrincipalFindings:Inalargeantiretroviraltherapy(ART)programinwesternKenya,weassessedtheimpact ofLTFUonestimatingpatientmortalityamong8,977adultclientsofwhom,3,624wereLTFU.Overall,dropoutsweremore likely male (36.8% versus 33.7%; p=0.003), and younger than non-dropouts (35.3 versus 35.7 years old; p=0.020), with lowermedianCD4countat