dc.contributor.author |
Chi, B.H. |
|
dc.contributor.author |
Yiannoutsos, C.T. |
|
dc.contributor.author |
Westfall, A.O. |
|
dc.contributor.author |
Newman, J.E. |
|
dc.contributor.author |
Zhou, J. |
|
dc.contributor.author |
Cesar, C. |
|
dc.contributor.author |
Brinkhof, M.W.G. |
|
dc.contributor.author |
Mwango, A. |
|
dc.contributor.author |
Balestre, E. |
|
dc.contributor.author |
Carriquiry, G. |
|
dc.contributor.author |
Sirisanthana, T. |
|
dc.contributor.author |
Mukumbi, H. |
|
dc.contributor.author |
Martin, J.N. |
|
dc.contributor.author |
Grimsrud, A. |
|
dc.contributor.author |
Bacon, M. |
|
dc.contributor.author |
Thiebaut, R. |
|
dc.date.accessioned |
2022-01-18T19:34:37Z |
|
dc.date.available |
2022-01-18T19:34:37Z |
|
dc.date.issued |
2011 |
|
dc.identifier.uri |
https://hdl.handle.net/20.500.12866/11060 |
|
dc.description.abstract |
Background: Although patient attrition is recognized as a threat to the long-term success of antiretroviral therapy programs worldwide, there is no universal definition for classifying patients as lost to follow-up (LTFU). We analyzed data from health facilities across Africa, Asia, and Latin America to empirically determine a standard LTFU definition. Methods and Findings: At a set "status classification" date, patients were categorized as either "active" or "LTFU" according to different intervals from time of last clinic encounter. For each threshold, we looked forward 365 d to assess the performance and accuracy of this initial classification. The best-performing definition for LTFU had the lowest proportion of patients misclassified as active or LTFU. Observational data from 111 health facilities-representing 180,718 patients from 19 countries-were included in this study. In the primary analysis, for which data from all facilities were pooled, an interval of 180 d (95% confidence interval [CI]: 173-181 d) since last patient encounter resulted in the fewest misclassifications (7.7%, 95% CI: 7.6%-7.8%). A secondary analysis that gave equal weight to cohorts and to regions generated a similar result (175 d); however, an alternate approach that used inverse weighting for cohorts based on variance and equal weighting for regions produced a slightly lower summary measure (150 d). When examined at the facility level, the best-performing definition varied from 58 to 383 d (mean = 150 d), but when a standard definition of 180 d was applied to each facility, only slight increases in misclassification (mean = 1.2%, 95% CI: 1.0%-1.5%) were observed. Using this definition, the proportion of patients classified as LTFU by facility ranged from 3.1% to 45.1% (mean = 19.9%, 95% CI: 19.1%-21.7%). Conclusions: Based on this evaluation, we recommend the adoption of ≥180 d since the last clinic visit as a standard LTFU definition. Such standardization is an important step to understanding the reasons that underlie patient attrition and establishing more reliable and comparable program evaluation worldwide. |
en_US |
dc.language.iso |
eng |
|
dc.publisher |
Public Library of Science |
|
dc.relation.ispartofseries |
PLoS Medicine |
|
dc.rights |
info:eu-repo/semantics/restrictedAccess |
|
dc.rights.uri |
https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es |
|
dc.subject |
Humans |
en_US |
dc.subject |
cohort analysis |
en_US |
dc.subject |
Cohort Studies |
en_US |
dc.subject |
controlled study |
en_US |
dc.subject |
rural area |
en_US |
dc.subject |
Delivery of Health Care |
en_US |
dc.subject |
Latin America |
en_US |
dc.subject |
South and Central America |
en_US |
dc.subject |
HIV Infections |
en_US |
dc.subject |
Human immunodeficiency virus infection |
en_US |
dc.subject |
statistics |
en_US |
dc.subject |
HIV |
en_US |
dc.subject |
Follow-Up Studies |
en_US |
dc.subject |
standardization |
en_US |
dc.subject |
highly active antiretroviral therapy |
en_US |
dc.subject |
urban area |
en_US |
dc.subject |
health care delivery |
en_US |
dc.subject |
Antiretroviral Therapy, Highly Active |
en_US |
dc.subject |
Patient Compliance |
en_US |
dc.subject |
health center |
en_US |
dc.subject |
Africa |
en_US |
dc.subject |
health care |
en_US |
dc.subject |
patient care |
en_US |
dc.subject |
health care facility |
en_US |
dc.subject |
accuracy |
en_US |
dc.subject |
data analysis |
en_US |
dc.subject |
Asia |
en_US |
dc.subject |
Terminology as Topic |
en_US |
dc.subject |
Lost to Follow-Up |
en_US |
dc.subject |
nomenclature |
en_US |
dc.subject |
patient coding |
en_US |
dc.subject |
treatment refusal |
en_US |
dc.title |
Universal definition of loss to follow-up in HIV treatment programs: A statistical analysis of 111 facilities in Africa, Asia, and Latin America |
en_US |
dc.type |
info:eu-repo/semantics/article |
|
dc.identifier.doi |
https://doi.org/10.1371/journal.pmed.1001111 |
|
dc.subject.ocde |
https://purl.org/pe-repo/ocde/ford#3.03.08 |
|
dc.relation.issn |
1549-1676 |
|