关键词: 乳腺癌, 治疗质量, 潜变量增长混合模型, 变化趋势

Abstract: Objective The Objective of this study was to analyze the longitudinal trend of multidimensional treatment quality of breast cancer based on the latent growth mixture model(LGMM),identify potential change patterns and influencing factors,and provide scientific basis for improving treatment quality and patient prognosis. Methods The quality monitoring data of breast cancer from four consecutive years were obtained in the National“Quality Monitoring System for Specific(single)Disease”;Based on the item response theory(IRT),the treatment quality of breast cancer in the three dimensions of preoperative examination,treatment,and outcome was calculated;LGMM was constructed to analyze the independent and joint change trend of breast cancer treatment quality in all dimensions,and the optimal model was determined based on practical significance and statistical indicators. Results In the independent trend analysis,2 potential categories were identified for preoperative examination,treatment,and outcome dimensions.Among them,9% showed a rapid upward trend in the preoperative examination dimension,and 91% showed a relatively stable trend;The stable growth accounted for 23% and slow decline accounted for 77% in the treatment dimension;13% of the outcome dimensions showed an upward trend,while 87% showed a downward trend.In the joint trend analysis of changes,2 potential categories were identified:the first category accounted for about 8%,and the preoperative examination dimension of this category had a good treatment quality,with mean intercepts and slopes of 3.326 and 3.367,respectively.The treatment quality in the treatment and outcome dimensions had steadily improved;The second category accounted for about 92%,and the treatment quality in this dimension was relatively good.Its mean intercept and slope were 0.548 and 0.018,respectively.There is still room for improvement in the treatment quality of the preoperative examination and outcome dimensions;BMI and M stage in patient characteristics are important influencing factors on the trend of combined changes in treatment quality. Conclusion The treatment quality of breast cancer during this study period has improved to varying degrees in all dimensions of preoperative examination,treatment and outcome;In the joint trend analysis of the three dimensions,the improvement of treatment quality in the preoperative examination dimension can provide feasible references for subsequent treatment and achieve the goal of reducing complications.

Key words: Breast cancer, Quality of treatment, Latent variable growth mixture model, Trend of change