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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Monitoramento da sobreviv?ncia de portadores de c?ncer de boca e orofaringe no RN via gr?fico Rast Cusum

Euflausino, Waleska Cristina 16 December 2016 (has links)
Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-03-12T14:16:55Z No. of bitstreams: 1 WaleskaCristinaEuflausino_DISSERT.pdf: 2155309 bytes, checksum: 4d1605e644787439d12a4dd235990b92 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-03-14T19:58:05Z (GMT) No. of bitstreams: 1 WaleskaCristinaEuflausino_DISSERT.pdf: 2155309 bytes, checksum: 4d1605e644787439d12a4dd235990b92 (MD5) / Made available in DSpace on 2018-03-14T19:58:05Z (GMT). No. of bitstreams: 1 WaleskaCristinaEuflausino_DISSERT.pdf: 2155309 bytes, checksum: 4d1605e644787439d12a4dd235990b92 (MD5) Previous issue date: 2016-12-16 / T?cnicas de controle estat?stico de processos (CEP), comumente usadas em problemas industriais, podem tamb?m ser aplicadas na ?rea da sa?de, tendo em vista que a qualidade em procedimentos m?dicos faz parte integrante do dia a dia nas estruturas hospitalares. Contudo, neste caso, a popula??o em estudo n?o pode ser considerada homog?nea como mercadorias em uma linha de produ??o. A aplica??o do CEP na ?rea de sa?de precisa admitir a exist?ncia de heterogeneidade, levando em considera??o caracter?sticas particulares de cada paciente como, por exemplo, sexo, idade, al?m de medidas que reflitam as condi??es gerais de sa?de. Neste sentido, alguns autores prop?em o monitoramento do tempo de sobreviv?ncia de pacientes, atrav?s de um gr?fico de controle de Somas Acumuladas - CUSUM (Cumulative Sum), ajustado para incorporar o risco de cada indiv?duo por meio de um modelo param?trico de regress?o. Este gr?fico ? chamado pelos autores de Gr?fico de Controle CUSUM Ajustado ao Risco (RAST CUSUM), e os resultados te?ricos foram desenvolvidos para monitorar tempos at? a ocorr?ncia de um evento, mesmo quando estes est?o sujeito a informa??es incompletas (censura ? direita), atrav?s do modelo Weibull, muito comum na modelagem de dados de sobreviv?ncia. Neste trabalho o gr?fico RAST CUSUM Weibull foi empregado com o objetivo geral de monitorar, em um estudo retrospectivo, os tempos de sobreviv?ncia dos pacientes diagnosticados com c?ncer de boca e orofaringe da Liga Norte Riograndense Contra o C?ncer no per?odo de 2001 a 2013. Os dados deste trabalho s?o oriundos da base de dados da Liga sendo registradas al?m das datas do diagn?stico e da ?ltima consulta na institui??o, caracter?sticas s?cio demogr?ficas e cl?nicas dos pacientes, consideradas como potenciais fatores de risco para redu??o no tempo m?dio de sobreviv?ncia desses indiv?duos. Como resultado do monitoramento, que levou em considera??o os fatores localiza??o e tamanho do tumor, tipo do primeiro tratamento adotado e hist?rico familiar, foi detectado um aumento de 20 % no tempo m?dio de sobreviv?ncia dos pacientes a partir do ano 2005. / Statistical process control techniques are commonly used in industrials problems and can also be applied in the health area, since quality in medical procedures are an integral part of day-to-day hospital structures. However, in this case, the population can not be regarded as homogeneous as goods in a production line. The application of the CEP in the health area must admit the existence of heterogeneity, taking into account particular characteristics of each patient with, for example, gender, age, and measures that reflect the general health conditions. In this sense, some authors propose monitoring survival time of patients, through a CUSUM (Cumulative Sum) chart, adjusted to incorporate the risk of each individual by a parametric regression model. This chart is called by the authors of RAST CUSUM, and the theoretical results were developed to monitor times until the occurrence of an event, even when they are subject to incomplete information (right censoring), considering for that the Weibull model, which is very used to model survival data. In this work the RAST CUSUM Weibull graph was used in a retrospective study, to monitoring the survival of patients with oral and oropharyngeal cancer, treated on the Northern Riograndense League of the c?ncer, from 2001 to 2013. The data of this work come from the data base of the hospital being registered beyond the dates of diagnosis and last visit to the institution, socio-demographic characteristics and clinics of patients, considered as potential risk factors for mean survival time of these individuals. As a result of the monitoring that considered the location and size of the tumor, type of the first treatment adopted and family history as risk factors, an increase of 20% in the mean survival time of the patients from 2005 was detected.

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