Exploring Factors Influencing Patient Delay Behavior in Oral Cancer: The Development of a Risk Prediction Model in Western China.
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BACKGROUND AND AIMS: To study the unknown influencing factors of delayed medical treatment behavior in oral cancer patients in western China and to develop a prediction model on the risk of delayed medical treatment in oral cancer patients. METHOD: We investigated oral cancer patients attending a tertiary Grade A dental hospital in western China from June 2022 to July 2023. The logistic regression and four machine learning models (nearest neighbors, the RBF SVM, random forest, and QDA) were used to identify risk factors and establish a risk prediction model. We used the established model to predict the data before and after the COVID-19 pandemic and test whether the prediction effect can still remain stable and accurate under the interference of COVID-19. RESULT: Out of the 495 patients included in the study, 122 patients (58.65%) delayed seeking medical treatment before the lifting of the restrictions of the pandemic, while 153 patients (53.13%) did so after the lifting of restrictions. The logistic regression model revealed that living with adult children was a protective factor for patients in delaying seeking medical attention, regardless of the implementation of pandemic control measures. After comparing each model, it was found that the statistical indicators of the random forest algorithm such as the AUC score (0.8380) and specificity (0.8077) ranked first, with the best prediction performance and stable performance. CONCLUSIONS: This study systematically elucidates the critical factors influencing patient delay behavior in oral cancer diagnosis and treatment, employing a comprehensive risk prediction model that accurately identifies individuals at an elevated risk of delay. It represents a pioneering large-scale investigation conducted in western China, focusing explicitly on the multifaceted factors affecting the delayed medical treatment behavior of oral cancer patients. The findings underscore the imperative of implementing early intervention strategies tailored to mitigate these delays. Furthermore, this study emphasizes the pivotal role of robust social support systems and positive family dynamics in facilitating timely access to healthcare services for oral cancer patients, thereby potentially improving outcomes and survival rates.