Acta haematologica · 2026
Global Disparities in Multiple Myeloma Quality-of-Care Indicators and Their Association with Socioeconomic Development and Behavioral Risk Factors: An Analysis of GBD 2021 Data.
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Liu Yulu, Hou Yan, Sun Xiangdong, Huan Zhishuo, Long Yingran, Li Jiajia, Han Xue, Zhang Jiangbo, Zhang Juanjuan
Аннотация
INTRODUCTION: To analyze global quality of multiple myeloma (MM) care and factors associated with its variation using the Quality of Care Index (QCI).
METHODS: Data were obtained from the Global Burden of Disease database. The QCI for MM was calculated globally and nationally using principal component analysis. Disparities were assessed via the Gender Disparity Ratio (GDR), Slope Index of Inequality (SII), and Concentration Index. Future trends were projected using an Autoregressive Integrated Moving Average model. The ecological correlations of modifiable behavioral risk factors and the Socio-demographic Index (SDI) with the QCI were explored using logistic regression and stratified analysis with summary exposure value data.
RESULTS: The global MM care quality improved significantly (QCI: 45.76 to 59.24). Gender equity increased (GDR: 1.06 to 0.97), but cross-national inequality widened (SII: 36.07 to 54.19). SDI strongly associated with QCI (R=0.815, p<0.001). Projections indicate that the global QCI for MM will rise from 59.24 in 2021 to 61.04 in 2036. High composite behavioral risk was positively associated with QCI (OR=5.06, 95% CI: 2.81-9.31). Regarding the QCI of MM, a significant interaction was observed between high body-mass index and the SDI, alongside a significant joint effect of the behavioral risk factors and the SDI. After adjusting for SDI in supplementary analyses, only dietary risks remained significantly associated with a lower QCI (OR = 0.919, 95% CI: 0.859-0.984).
CONCLUSION: While our findings reveal substantial gains in MM care quality, they also underscore the critical need for heightened attention to regions with high dietary risks, particularly those with lower SDI. These ecological correlations warrant confirmation in individual-level studies.
METHODS: Data were obtained from the Global Burden of Disease database. The QCI for MM was calculated globally and nationally using principal component analysis. Disparities were assessed via the Gender Disparity Ratio (GDR), Slope Index of Inequality (SII), and Concentration Index. Future trends were projected using an Autoregressive Integrated Moving Average model. The ecological correlations of modifiable behavioral risk factors and the Socio-demographic Index (SDI) with the QCI were explored using logistic regression and stratified analysis with summary exposure value data.
RESULTS: The global MM care quality improved significantly (QCI: 45.76 to 59.24). Gender equity increased (GDR: 1.06 to 0.97), but cross-national inequality widened (SII: 36.07 to 54.19). SDI strongly associated with QCI (R=0.815, p<0.001). Projections indicate that the global QCI for MM will rise from 59.24 in 2021 to 61.04 in 2036. High composite behavioral risk was positively associated with QCI (OR=5.06, 95% CI: 2.81-9.31). Regarding the QCI of MM, a significant interaction was observed between high body-mass index and the SDI, alongside a significant joint effect of the behavioral risk factors and the SDI. After adjusting for SDI in supplementary analyses, only dietary risks remained significantly associated with a lower QCI (OR = 0.919, 95% CI: 0.859-0.984).
CONCLUSION: While our findings reveal substantial gains in MM care quality, they also underscore the critical need for heightened attention to regions with high dietary risks, particularly those with lower SDI. These ecological correlations warrant confirmation in individual-level studies.