[abstract] DECOMPRESSION ILLNESS (DCI) AND SURVIVAL ANALYSIS

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[abstract] DECOMPRESSION ILLNESS (DCI) AND SURVIVAL ANALYSIS

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Title: [abstract] DECOMPRESSION ILLNESS (DCI) AND SURVIVAL ANALYSIS
Author: Vann, R; Denoble, P; Howle, L; Weber, P; Freiberger, J; Pieper, C
Abstract: BACKGROUND: Progress in investigating DCI severity and resolution has been gradual. We review key milestones and suggest survival analysis might be a logical next step. MATERIALS AND METHODS: The classifications Type 1 DCS (simple bends) and Type 2 DCS (serious) were introduced for compressed air work in 1960 and adopted for diving and aerospace in the 1970s. In the 1980s, these traditional DCS classifications were declared artificial, misleading, and diagnostically inconsistent, and classification by manifestation was proposed under the designation decompression illness. A more quantitative approach assigned weights to manifestations according to clinical judgment. The sum of the weights was a case severity score that was found to be significantly associated with residual symptoms. The need for clinically judged weights was avoided when logistic regression assessed the association of manifestations with residual symptoms. RESULTS: Survival analysis is used when time to event is the outcome of interest such as: (a) clinical trials comparing time to patient death for a drug versus placebo, or (b) epidemiologic surveys comparing the relative risk of an event between groups. Survival analysis can use information for censored patients (who are lost to follow-up) whereas methods such as logistic regression cannot. For DCI, the variable of interest is the time to recovery for a particular manifestation. Survival analysis is a general term for various regression models (e.g., proportional hazards, time dependent covariates, exponential, normal, log-normal) that could be used to investigate potential DCI explanatory and control variables such as how recovery time is influenced by age, sex, body mass index, first aid oxygen, time to recompression, or multiple recompressions. CONCLUSIONS: Application of survival analysis to DCI data would require more specific case information than is commonly recorded.
Description: Abstract of the Undersea and Hyperbaric Medical Society, Inc. Annual Scientific Meeting, Las Vegas, Nevada, USA. (http://www.uhms.org)
URI: http://archive.rubicon-foundation.org/9091
Date: 2009

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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