1
|
Lin Z, Yu LY, Pan SY, Cao Y, Lin P. Development of a Prediction Model and Corresponding Scoring Table for Postherpetic Neuralgia Using Six Machine Learning Algorithms: A Retrospective Study. Pain Ther 2024; 13:883-907. [PMID: 38834881 PMCID: PMC11254897 DOI: 10.1007/s40122-024-00612-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 05/03/2024] [Indexed: 06/06/2024] Open
Abstract
INTRODUCTION Postherpetic neuralgia (PHN), a complication of herpes zoster, significantly impacts the quality of life of affected patients. Research indicates that early intervention for pain can reduce the occurrence or severity of PHN. This study aims to develop a predictive model and scoring table to identify patients at risk of developing PHN following acute herpetic neuralgia, facilitating informed clinical decision-making. METHODS We conducted a retrospective review of 524 hospitalized patients with herpes zoster at The First Affiliated Hospital of Zhejiang Chinese Medical University from December 2020 to December 2023 and classified them according to whether they had PHN, collecting a comprehensive set of 30 patient characteristics and disease-related indicators, 5 comorbidity indicators, 2 disease score values, and 10 serological indicators. Relevant features associated with PHN were identified using the least absolute shrinkage and selection operator (LASSO). Then, the patients were divided into a training set and a test set in a 4:1 ratio, with comparability tested using univariate analysis. Six models were established in the training set using machine learning methods: support vector machines, logistic regression, random forest, k-nearest neighbor, gradient boosting, and neural network. The performance of these models was evaluated in the test set, and a nomogram based on logistic regression was used to create a PHN prediction score table. RESULTS Eight non-zero characteristic variables selected from the LASSO regression results were included in the model, including age [area under the curve (AUC) = 0.812, p < 0.001], Numerical Rating Scale (NRS) (AUC = 0.792, p < 0.001), receiving treatment time (AUC = 0.612, p < 0.001), rash recovery time (AUC = 0.680, p < 0.001), history of malignant tumor (AUC = 0.539, p < 0.001), history of diabetes (AUC = 0.638, p < 0.001), varicella-zoster virus immunoglobulin M (AUC = 0.620, p < 0.001), and serum nerve-specific enolase (AUC = 0.659, p < 0,001). The gradient boosting model outperformed other classifier models on the test set with an AUC of 0.931, 95% confidence interval (CI) (0.882-0.980), accuracy of 0.886 (95% CI 0.809-0.940). In the test set, our predictive scoring table achieved an AUC of 0.820 (95% CI 0.869-0.970) with accuracy of 0.790 (95% CI 0.700-0.864). CONCLUSION This study presents a methodology for predicting the development of postherpetic neuralgia in shingles patients by analyzing historical case data, employing various machine learning techniques, and selecting the optimal model through comparative analysis. In addition, a logistic regression model has been used to create a scoring table for predicting the postherpetic neuralgia.
Collapse
Affiliation(s)
- Zheng Lin
- First Clinical Medical College, Zhejiang Chinese Medical University, No. 548 Binwen Road, Binjiang District, Hangzhou, 310006, Zhejiang, China
- The First Affiliated Hospital, Zhejiang Chinese Medical University, 54, Post and Circuit Road, Shangcheng District, Hangzhou, 310054, Zhejiang, China
| | - Lu-Yan Yu
- First Clinical Medical College, Zhejiang Chinese Medical University, No. 548 Binwen Road, Binjiang District, Hangzhou, 310006, Zhejiang, China
- The First Affiliated Hospital, Zhejiang Chinese Medical University, 54, Post and Circuit Road, Shangcheng District, Hangzhou, 310054, Zhejiang, China
| | - Si-Yi Pan
- First Clinical Medical College, Zhejiang Chinese Medical University, No. 548 Binwen Road, Binjiang District, Hangzhou, 310006, Zhejiang, China
- The First Affiliated Hospital, Zhejiang Chinese Medical University, 54, Post and Circuit Road, Shangcheng District, Hangzhou, 310054, Zhejiang, China
| | - Yi Cao
- The First Affiliated Hospital, Zhejiang Chinese Medical University, 54, Post and Circuit Road, Shangcheng District, Hangzhou, 310054, Zhejiang, China
| | - Ping Lin
- Geriatric Department, The Third Hospital of Hangzhou, 38, Xihu Avenue, Shangchenq Distinct, Hangzhou, 310009, Zhejiang, China.
| |
Collapse
|
2
|
AlKhowailed MS, Alotaibi HM, Aljurays AS, Mohammad RA, Alqahtani GM, Al Abdulmonem W, Alhumidi A, Alhomaidan HT, Alqossayir FM. Public Perception in Saudi Arabia Toward Herpes Zoster and Its Vaccination: A Cross-Sectional Study. Cureus 2024; 16:e58360. [PMID: 38628378 PMCID: PMC11019398 DOI: 10.7759/cureus.58360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2024] [Indexed: 04/19/2024] Open
Abstract
Background Herpes zoster (HZ) or shingles, arises from the reactivation of the varicella zoster virus (VZV), mainly affecting older and immunocompromised individuals. Despite the efficacy of vaccines, vaccination rates in Saudi Arabia are low. Thus, this study aimed to assess the knowledge, attitude, and practice of the Saudi Arabian population toward HZ and its vaccination. Methods An observational cross-sectional study was carried out to evaluate the public perception in Saudi Arabia toward HZ and its vaccination, during the period from January to March 2024. Participants were selected using a non-probability, convenience sampling method, with recruitment facilitated through WhatsApp, a messaging app. Data has been analyzed using the statistical software Statistical Package for Social Sciences (SPSS), version 26.0 (IBM Corp., Armonk, NY). A p-value of <0.05 has been used to report the statistical significance. Results The study's demographic profile included 1237 participants, predominantly younger than 30 years (65.5%), with a female majority (65.7%). Public knowledge about HZ was limited, only 29.6% of participants recognized the risk of HZ post-chickenpox. More than half of the participants were not aware that the vaccine is provided by the Saudi Ministry of Health (MOH) for certain groups. However, over 75% are willing to receive the HZ vaccine upon physician recommendation. Conclusion This study shows a general lack of awareness about HZ and its vaccination in Saudi Arabia, including misconceptions about vaccination availability, recommendations, and the disease's complications. Gender differences in attitude and interest highlight the potential for tailored educational campaigns. Addressing these issues is essential for improving vaccination rates and mitigating HZ's impact.
Collapse
Affiliation(s)
| | - Hatim M Alotaibi
- Department of Medicine, Riyadh Third Health Culster, Ad-Dawadmi, SAU
| | - Amwaj S Aljurays
- Department of Dermatology, College of Medicine, Qassim University, Buraydah, SAU
| | - Reem A Mohammad
- Department of Dermatology, College of Medicine, Qassim University, Buraydah, SAU
| | - Ghadeer M Alqahtani
- Department of Dermatology, College of Medicine, Qassim University, Buraydah, SAU
| | | | - Ahmed Alhumidi
- Department of Pathology, King Saud University, Riyadh, SAU
| | - Homaidan T Alhomaidan
- Department of Family and Community Medicine, College of Medicine, Qassim University, Buraydah, SAU
| | - Fuhaid M Alqossayir
- Department of Family and Community Medicine, College of Medicine, Qassim University, Buraydah, SAU
| |
Collapse
|
3
|
Ceccarelli A, Tamarri F, Angelini R, Bakken E, Concari I, Giannoccaro E, Domeniconi G, Morri M, Reali C, Righi F, Serra S, Semprini G, Silvestrini G, Turri V, Gori D, Montalti M. Herpes Zoster Vaccine Uptake and Active Campaign Impact, a Multicenter Retrospective Study in Italy. Vaccines (Basel) 2024; 12:51. [PMID: 38250864 PMCID: PMC10818709 DOI: 10.3390/vaccines12010051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/29/2023] [Accepted: 01/01/2024] [Indexed: 01/23/2024] Open
Abstract
The Herpes Zoster (HZ) vaccination has proven both safe and effective in alleviating conditions related to HZ, leading to significant cost savings in national healthcare and social systems. In Italy, it is recommended and provided free of charge to individuals aged 65 and older. To achieve broad vaccination coverage, alongside ordinary immunization campaigns, active and catch-up campaigns were implemented. This retrospective observational study aimed to observe the vaccination coverage achieved in the Romagna Local Health Authority (LHA) during the 2023 active campaign, with a secondary goal of assessing the impact of the 2022 catch-up campaign and the 2023 active campaign compared to ordinary campaigns. As of 3 July 2023, an overall vaccine uptake of 13.5% was achieved among individuals born in 1958, with variations among the four LHA centers ranging from 10.2% to 17.7%. Catch-up and active campaigns together contributed to nearly half of the achieved coverage in Center No. 1 and a quarter in Center No. 2. Notably, individuals born in 1957, not included in the Center No. 2 catch-up campaign, reached significantly lower vaccination coverage compared to other cohorts and centers. Analyzing the use of text messages for active campaigns, it was observed that cohort groups did not show substantial differences in text-message utilization for warnings. However, having relatives who had experienced HZ-related symptoms significantly reduced the reliance on text messages as warnings. These results highlighted how catch-up and active campaigns effectively increased vaccine coverage. Nevertheless, differences in uptake among different centers within the same LHA and the limited contribution of other information sources compared to text messages suggest the necessity of designing campaigns involving all available channels and stakeholders to maximize vaccine uptake.
Collapse
Affiliation(s)
- Andrea Ceccarelli
- Operative Unit of Hygiene and Public Health-Forlì and Cesena, Department of Public Health, Romagna Local Health Authority, 47522 Cesena, Italy (G.D.)
- Unit of Hygiene and Medical Statistics, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Federica Tamarri
- Operative Unit of Hygiene and Public Health-Forlì and Cesena, Department of Public Health, Romagna Local Health Authority, 47522 Cesena, Italy (G.D.)
| | - Raffaella Angelini
- Operative Unit of Hygiene and Public Health-Ravenna, Department of Public Health, Romagna Local Health Authority, 48121 Ravenna, Italy
| | - Elizabeth Bakken
- Operative Unit of Hygiene and Public Health-Rimini, Department of Public Health, Romagna Local Health Authority, 47924 Rimini, Italy
| | - Ilaria Concari
- Operative Unit of Hygiene and Public Health-Rimini, Department of Public Health, Romagna Local Health Authority, 47924 Rimini, Italy
| | - Elsa Giannoccaro
- Operative Unit of Hygiene and Public Health-Rimini, Department of Public Health, Romagna Local Health Authority, 47924 Rimini, Italy
| | - Giada Domeniconi
- Operative Unit of Hygiene and Public Health-Forlì and Cesena, Department of Public Health, Romagna Local Health Authority, 47522 Cesena, Italy (G.D.)
| | - Michela Morri
- Operative Unit of Hygiene and Public Health-Rimini, Department of Public Health, Romagna Local Health Authority, 47924 Rimini, Italy
| | - Chiara Reali
- Operative Unit of Hygiene and Public Health-Forlì and Cesena, Department of Public Health, Romagna Local Health Authority, 47522 Cesena, Italy (G.D.)
| | - Francesca Righi
- Operative Unit of Hygiene and Public Health-Forlì and Cesena, Department of Public Health, Romagna Local Health Authority, 47522 Cesena, Italy (G.D.)
| | - Silvia Serra
- Operative Unit of Hygiene and Public Health-Ravenna, Department of Public Health, Romagna Local Health Authority, 48121 Ravenna, Italy
| | - Gianmaria Semprini
- Operative Unit of Hygiene and Public Health-Rimini, Department of Public Health, Romagna Local Health Authority, 47924 Rimini, Italy
| | - Giulia Silvestrini
- Operative Unit of Hygiene and Public Health-Ravenna, Department of Public Health, Romagna Local Health Authority, 48121 Ravenna, Italy
| | - Valentina Turri
- Operative Unit of Hygiene and Public Health-Ravenna, Department of Public Health, Romagna Local Health Authority, 48121 Ravenna, Italy
| | - Davide Gori
- Unit of Hygiene and Medical Statistics, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Marco Montalti
- Operative Unit of Hygiene and Public Health-Forlì and Cesena, Department of Public Health, Romagna Local Health Authority, 47522 Cesena, Italy (G.D.)
- Unit of Hygiene and Medical Statistics, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| |
Collapse
|
4
|
Bohamad AH, Alojail HY, Alabdulmohsin LA, Alhawl MA, Aldossary MB, Altoraiki FM, Almulhim AY, Almulhim A, Alabdulathim S, Almarri F. Knowledge About the Herpes Zoster (HZ) Vaccine and Its Acceptance Among the Population in Al-Ahsa City in the Kingdom of Saudi Arabia. Cureus 2023; 15:e50329. [PMID: 38205447 PMCID: PMC10779340 DOI: 10.7759/cureus.50329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2023] [Indexed: 01/12/2024] Open
Abstract
Introduction Herpes zoster (HZ), caused by the varicella-zoster virus (VZV), poses a public health concern in Saudi Arabia, with an increasing number of cases reported in recent years. This study aimed to assess the knowledge and acceptance of the herpes zoster vaccine among Saudi Arabian citizens in Al-Ahsa. Methodology A descriptive cross-sectional study was conducted using online surveys administered via social media platforms. The study was conducted in Al-Ahsa, a city located in the Eastern Province of Saudi Arabia. Al-Ahsa serves as a representative urban area within Saudi Arabia. Result The study found a high level of awareness and knowledge about the vaccine, with 78.2% of the participants having heard of herpes zoster. The majority considered the vaccine effective (89%) and believed it was available in Saudi Arabia (87%). However, the vaccination rate was only 8%. The study revealed varied opinions on the target population for vaccination, with 39.7% favoring immunocompromised patients and 38.1% choosing individuals above 50 years. The reasons for not being vaccinated included a lack of information (38.3%) and the belief of being in good health (37.3%). Conclusion The findings suggest a need for targeted educational campaigns to address misconceptions and promote vaccination, particularly among healthcare providers and the recommended target populations. Future research should explore barriers to vaccination to inform tailored interventions.
Collapse
|