РАЗРАБОТКА РИСК-ОРИЕНТИРОВАННОГО ПОДХОДА В ПРОФИЛАКТИКЕ СТАРЧЕСКОЙ КАТАРАКТЫ НА ОСНОВЕ КОМОРБИДНОЙ ПАТОЛОГИИ

Abstract

Significance. Cataracts are the second most common cause of low vision and blindness. In this regard, development of a new analytical approach is required to optimize algorithms of preventive measures. The purpose of the study is to develop a method of screening diagnostics of age-related cataract among people aged 40-99, based on comorbid pathology, as well as an algorithm for stratification into target groups depending of the risk for senile cataract development. Material and methods. The study is based on information extracted from electronic medical records (EMRs) of patients aged 40-99 residing in Tambov and assigned to the city polyclinic (n=38328). The technique was developed using a binary logistic regression analysis with a step-by-step algorithm for including variables, where age-related cataract acted as the dependent variable, and age-related cataract risk factors associated with chronic diseases were used as independent variables. The models were compared by building ROC curves with calculations of the area under the curve (AUC). Results. A screening technique has been developed to identify individuals at high risk for developing age-related cataract among people aged 40 -99 based on data on chronic diseases associated with age-related cataract, including hypertension, coronary heart disease, cerebrovascular diseases, varicose veins of the lower extremities, and diabetes mellitus, taking into account age standardization. Data on the level of risk for developing age-related cataract made it possible to develop an algorithm for stratifying population into target groups, depending on the required level of sensitivity and specificity. Conclusion. Based on the data on cardiometabolic diseases associated with age-related cataract, a methodology was developed that allows to establish the risk level for developing age-related cataract among people aged 40-99, and an algorithm for stratification into target groups. Scope of application. The acquired knowledge can be used in the process of developing differentiated measures of primary prevention of age-related cataract, taking into account target groups and the established modifiable risk factors.