与延迟射精相关的诊断和药物。

IF 2.6 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Sexual Medicine Pub Date : 2023-08-01 DOI:10.1093/sexmed/qfad040
Evan Mulloy, Amy Zhang, Federico Balladelli, Francesco Del Giudice, Frank Glover, Michael L Eisenberg
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引用次数: 0

摘要

背景:延迟射精(DE)是一种对性活跃的男性造成严重困扰的疾病。DE的病因在很大程度上是特发性的,与此相关的临床因素所知甚少。目的:我们试图使用数据挖掘技术来检查一组广泛的健康状况和药物治疗,以确定与DE相关的因素。方法:使用保险索赔数据库,我们评估了所有诊断为DE的男性,并将他们与患有泌尿系统原因的其他男性性功能障碍(即勃起功能障碍[ED]和佩罗尼病[PD])的男性进行了1:1的匹配。鉴于DE的患病率较低,我们采用随机森林方法对DE与对照组进行分类,并使用大量预测因子和最小绝对收缩和选择算子(LASSO)进行交叉验证。我们使用了高性能的广义线性模型和多元逻辑模型。曲线下的面积被用来展示分类器的性能,比值比被用来表示每个预测器的风险。我们还评估了不同种族/民族的DE患病率差异。结果:确定了与DE相关的临床因素(即诊断和药物)。结果:共有11 602名DE患者与PD和ED患者进行了匹配。我们重点研究了所有模型中与DE相关性最强的20个因素。与其他男性性功能障碍(即ED和PD)相比,与DE呈正相关的因素包括男性不育、睾丸功能障碍、焦虑、脂质代谢障碍、α -肾上腺素能阻滞剂的使用、贫血、抗抑郁药的使用以及精神分裂症或分裂情感性障碍等精神病。此外,几种疾病的发病率因种族/族裔而异。例如,与临床意义相比,5%的亚洲男性存在男性不育症:几种医学条件和药物治疗与DE有关,研究结果可能为DE的病因提供深入了解并提供治疗选择。优势和局限性:据我们所知,这项研究是第一次使用数据挖掘技术来调查医疗条件/药物制剂与随后DE发展之间的关系。鉴于所有男性都参加了商业保险,我们的研究结果的普遍性受到限制。结论:DE与多种疾病有关,这一发现可能有助于确定这种疾病的病因。
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Diagnoses and medications associated with delayed ejaculation.

Background: Delayed ejaculation (DE) is a disorder that can cause significant distress for sexually active men. The etiology of DE is largely idiopathic, with even less being known about clinical factors associated with the condition.

Aim: We sought to use data mining techniques to examine a broad group of health conditions and pharmaceutical treatments to identify factors associated with DE.

Methods: Using an insurance claims database, we evaluated all men with a diagnosis of DE and matched them to a cohort (1:1) of men with other male sexual disorders of urologic origin (ie, erectile dysfunction [ED] and Peyronie's disease [PD]). Given the low prevalence of DE, we incorporated the random forest approach for classification of DE vs controls, with a plethora of predictors and cross-validation with the least absolute shrinkage and selection operator (LASSO). We used both a high-performance generalized linear model and a multivariate logistic model. The area under the curve was reported to demonstrate classifier performance, and odds ratios were used to indicate risks of each predictor. We also evaluated for differences in the prevalence of conditions in DE by race/ethnicity.

Outcomes: Clinical factors (ie, diagnoses and medications) associated with DE were identified.

Results: In total, 11 602 men with DE were matched to a cohort of men with PD and ED. We focused on the 20 factors with the strongest association with DE across all models. The factors demonstrating positive associations with DE compared to other disorders of male sexual dysfunction (ie, ED and PD) included male infertility, testicular dysfunction, anxiety, disorders of lipid metabolism, alpha adrenergic blocker use, anemia, antidepressant use, and psychoses such as schizophrenia or schizoaffective disorder. In addition, the prevalence of several conditions varied by race/ethnicity. For example, male infertility was present in 5% of Asian men compared to <2% of men of other races.

Clinical implications: Several medical conditions and pharmacologic treatments are associated with DE, findings that may provide insight into the etiology of DE and offer treatment options.

Strengths and limitations: This study is to our knowledge the first to use using data mining techniques to investigate the association between medical conditions/pharmacologic agents and the development of subsequent DE. The generalizability of our findings is limited given that all men were commercially insured.

Conclusion: DE is associated with multiple medical conditions, a finding that may help identify the etiology for this disorder.

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来源期刊
Sexual Medicine
Sexual Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
5.40
自引率
0.00%
发文量
103
审稿时长
22 weeks
期刊介绍: Sexual Medicine is an official publication of the International Society for Sexual Medicine, and serves the field as the peer-reviewed, open access journal for rapid dissemination of multidisciplinary clinical and basic research in all areas of global sexual medicine, and particularly acts as a venue for topics of regional or sub-specialty interest. The journal is focused on issues in clinical medicine and epidemiology but also publishes basic science papers with particular relevance to specific populations. Sexual Medicine offers clinicians and researchers a rapid route to publication and the opportunity to publish in a broadly distributed and highly visible global forum. The journal publishes high quality articles from all over the world and actively seeks submissions from countries with expanding sexual medicine communities. Sexual Medicine relies on the same expert panel of editors and reviewers as The Journal of Sexual Medicine and Sexual Medicine Reviews.
期刊最新文献
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