YADDA MARASA LAFIYA KE TAFIYA YANA NUNA ALAMAR CI GABAN ƘARIN ƘWAƘWALWA

Glioblastoma, ƙarin ƙwaƙwalwa da ya fi yawa a manya, yana da tsaka-tsakin tsawon rai (median survival) na kusan watanni 15 ko da tare da tiyata, maganin haskoki (radiotherapy) da maganin sinadarai (chemotherapy). Kamar sauran high-grade gliomas (ƙarin glioma masu tsanani), yana kawo asarar ayyukan jiki a hankali a hankali, kuma cutar takan ci gaba bayan wata huɗu zuwa shida da gano ta. Ana tabbatar da ci gaban cutar ne da MRI mai sinadarin bambanci (contrast-enhanced MRI) — hoto mai tsada, mai sa jin ƙuntatawa (claustrophobic), wanda galibi ba zai yiwu ga masu na’urar bugun zuciya (pacemaker) ba, ana yin sa duk bayan wata biyu zuwa uku kawai, kuma yana iya nuna cutar ne kawai bayan ta riga ta yi nisa.

Firikwensin da ake sakawa a jiki (wearable sensors) na iya cike giɓin da ke tsakanin hotuna. Amma kowane mara lafiya yana motsi daban, kuma canje-canjen sun dogara ne da inda ƙarin yake da yadda yake yaɗuwa. Taƙaitawa mafi sauƙi, adadin takun, na iya rasa abin da ke da muhimmanci: yadda mutum ke tafiya, ba yawan tafiyar kawai ba.

Firikwensin da ake sakawa kowace rana

Rishit Das, Barbora Barancikova da Matt Williams, na Imperial College London, sun yi amfani da bayanai daga binciken BrainWear, inda marasa lafiya masu high-grade glioma suka saka na’urar auna motsi (accelerometer) a wuyan hannu, kuma aka yi wa kowace ziyarar asibiti lakabin tsayayye (stable) ko mai ci gaba (progressive). Cikakken saitin bayanan ya ƙunshi marasa lafiya 78 da ziyarce-ziyarce 114 da aka yi wa lakabi.

Daga ɗanyen siginar, wani kayan aikin rarrabawa (classification tool) da aka ƙirƙira don UK Biobank ya zaɓo lokutan tafiya. An tace su, an yanka su zuwa guntaye na daƙiƙa 15 kuma aka rage su zuwa lanƙwasa ɗaya ta ƙarfin motsi a kan lokaci.

Karanta siffar tafiya

Don kwatanta tafiye-tafiye, ƙungiyar ta aro wani kayan aiki daga wani reshe na lissafi da ake kira rough path theory: path signatures. Signature tana taƙaita “siffar” siginar da ke buɗewa a kan lokaci, ta hanyar jerin integrals da aka saka cikin juna (nested integrals), ba tare da buƙatar horar da samfuri tukuna ba. Signatures sun riga sun yi aiki wajen gane haruffan Sinanci da aka rubuta da hannu da kuma ayyukan ɗan adam. Wani ma’auni mai alaƙa, SigMMD, yana ƙididdige yadda tarin sigina biyu suka bambanta: gwargwadon girmansa, gwargwadon bambancinsu.

Don tabbatar da cewa hanyar tana da ma’ana (sanity check), signatures sun bambance tafiya a fili daga barci, zama, tsayawa ko hawa a cikin abin hawa.

Kowane mara lafiya a matsayin ma’aunin kansa

Ga kowane lokaci tsakanin ziyarar asibiti biyu, kusan makonni biyu na farko na tafiya sun zama tushen ma’auni (baseline) na mara lafiyar. An kwatanta kowace rana ta baya da shi ta amfani da SigMMD, kuma aka ɗauki matsakaicin ƙimomin yau da kullum zuwa lamba ɗaya ga kowace ziyara.

Su kaɗai, waɗannan lambobin da ƙyar suka raba ziyarar da ke tsayayye da ta mai ci gaba: marasa lafiya kawai suna tafiya daban-daban sosai. Don haka marubutan sun raba kowace ƙima da matsakaicin mara lafiyar ɗaya a lokacin ziyarce-ziyarcen tsayayyu. Rabo (ratio) sama da 1 yana nufin cewa a wannan karon, tafiyar mara lafiyar ta kauce nesa da tushen ma’auninta fiye da yadda ta saba lokacin da cutar ke tsayayye.

Abin da lambobin ke faɗi

Isassun bayanai da aƙalla ziyara ɗaya tsayayye sun samu ga marasa lafiya 11 da ziyarce-ziyarce 26 — 11 masu ci gaba, 15 tsayayyu — jimillar sa’o’i 3,030 na tafiya. Rabon da aka keɓance ga kowane mutum ya fi girma a ziyarce-ziyarce masu ci gaba (p = 0.016 a wani gwaji da ke jujjuya lakabi a cikin kowane mara lafiya: kusan kashi 1.6% na yiwuwar samun irin wannan babban bambanci idan lakabin ba su da wata ma’ana).

Idan aka yi amfani da shi a matsayin iyakar gargaɗi ɗaya, kuma aka gwada shi kowane lokaci a kan mara lafiyar da aka bari a waje lokacin daidaitawa (tuning), rabon ya kai yankin ƙarƙashin lanƙwasa (area under the curve) — maki da ke auna yadda yake sanya ziyarce-ziyarce masu ci gaba sama da tsayayyu, daga 0.5 (sa’a kawai) zuwa 1 (cikakke) — na 0.85 (kewayon 95%: 0.66 zuwa 0.99). Ya yi gargaɗi a kan 8 cikin 11 na ziyarce-ziyarce masu ci gaba kuma ya kira kashi 80% na tsayayyun ziyarce-ziyarce tsayayyu daidai. Adadin takun, akasin haka, bai fi sa’a kawai ba: 0.44 ga wannan hanyar da aka keɓance, 0.42 ga wani samfuri na al’ada da ke amfani da kwanaki 60 kafin kowace ziyara.

Mataki na farko, ba gwaji ba tukuna

Marubutan sun jaddada iyakokin. Ƙungiyar marasa lafiyar (cohort) ƙanƙanuwa ce ƙwarai. Kuma tsayayyen ma’auni na kowane mara lafiya na iya haɗawa da ziyarce-ziyarcen tsayayyu da suka zo bayan ci gaban cuta, don haka har yanzu ba za a iya lissafa rabon a lokaci na ainihi (real time) ba. Binciken ya nuna cewa tafiya ta bambanta tsakanin lokutan tsayayye da na ci gaba; har yanzu bai nuna cewa firikwensin wuyan hannu zai iya gano ci gaban cuta kafin hoton ya gano ba. Don haka, sai ma’aunin ya dogara ne kawai da ziyarce-ziyarcen tsayayyu na baya, a cikin wata babbar ƙungiya da aka bi a kan lokaci.

Mataki na gaba da suka ba da shawara shi ne a riƙa bin ƙimomin yau da kullum ba tare da tsayawa ba maimakon ɗaya ga kowace ziyara, don a ga ko canji a yadda marasa lafiya ke tafiya zai iya nuna ainihin farkon taɓarɓarewarsu. Kafin nan, ɗamarar wuyan hannun ta kasance ra’ayin bincike, wanda ake nufin wata rana ya ƙarfafa hotunan da binciken asibiti, ba ya maye gurbinsu ba.