The aim of the study was to substantiate evidence-based (clinical and statistical) algorithm of risk assessment according to the complex of regional ecological factors, that is important for health assessment of children with dysplastic dependent pathology (DDP) of bronchopulmonary system (BPS). Materials and methods. Personalized analysis of the present factors in 252 children (with BPD and DDP BDS) of two administrative regions of Ukraine and healthy children of comparison group was accomplished. While examining the regional-population characteristics of healthy and sick children, specially compiled expert-prognostic chart was used, that was completed for each child and includes data on BPD or DDP BPS presence, and also characteristics of the particular regional ecological clusters (ECR). The results and discussion. According to comparative analysis data of 30 regional environmental factors, using standardized procedure, it was identified 10 the most informative factors and determined their prognostic value, also, the standardized algorithm of risk prediction of DDP BPS in children was developed. The aim, underlying innovative techniques, is attained by the measurement and complex account of personalized rate of the ecological environment state, the qualitative and quantitative evaluation of the generalized index of health quality was performed afterwards, and its level was determined using formula: HQР=(1– (1 –QH/QHn)100, where: HQР is the index of health quality; QH −the minimum entropy index of the represented regional-environmental measurements; QHn –index of sanalogic system entropy of certain individual; and when the value of this index is in the range 100 – 70%, the high health quality level is determined, 69-31% − average level, less than 30% − low health quality level. The algorithm verification was carried out among children of two groups (252 children with DDP and 252 without DDP) and was stated, that the error frequency of the first kind (high risk without pathology was identified) amounted to α=3,0%, while errors of the second kind (low risk with pathology was identified) β=7,2%. Thus, the specificity of the prognostic algorithm is 92,8%, and its efficiency is 97,0%, which enables to recommend it as a stage of population monitoring. Conclusions 1. The most informative risk factors were determined on the basis of actual prevalence research of 30 possible risk factors and their prognostic value was used as the criterion for risk assessment of DDP BPS in children. 2. The standardized pathometric tabular algorithm on the basis of sequential Wald analysis methodolody in Gubler Ye.V. modification was arranged and example of its implementation at the individual level was introduced. Implementation of given algorithm enables to record present significant risk factors and identify persons (and identical territorial ontogenetic groups) with high risk DDP of bronchopulmonary system. 3. Algorithm verification was carried out by inverse method among the children of two groups and it was determined that the error frequency of the first kind amounted to α=3,0%, while the second kind errors (low risk with pathology was defined) β=7,2%. Thus, the prognostic algorithm specificity is 92,8% and its efficiency − 97,0%, which enables to recommend it as a stage of population monitoring.
social medicine, health of children population, risk factors, bronchopulmonary system, organizational models
«Bulletin of problems biology and medicine» Issue 1 part 2 (127), 2016 year, 205-211 pages, index UDK 616-053.2: 614.2
