Evaluation of the effectiveness of an algorithm to predict COPD exacerbations in primary care: an interrupted time
Francesco Lapi1, Ettore Marconi1, Piergiuseppe De Rosa2
1Genomedics SRL, Via Sestese 61, 50141, Florence, Italy.
Objective:
To evaluate the impact of the Clinical Exacerbation Score for Health Search (CEX-HScore) on the frequency of registered chronic obstructive pulmonary disease (COPD) exacerbations and referrals to specialists in Italian primary care using an interrupted time series (ITS) analysis.
Methods:
Using data from an Italian federated network of general practitioners (GPs), we conducted an ITS analysis on GP-level (aggregated) indicators to assess changes in registration of moderate-to-severe COPD exacerbations and pulmonologist referrals before (up to January 2023) and after (up to June 2024) the implementation of CEX-HScore as a decision support system in GPs software.
Results:
The launch of the CEX-HScore on 1 January 2024 did not yield statistically significant increases in indicators quantifying monthly referral rates or coded exacerbations in the general COPD population. Instead, among incident COPD cases, a significant increase of 45% per month (P < .001) in the proportion of coded exacerbations out of total exacerbations was observed postintervention.
Conclusion:
These findings suggest that the implementation of CEX-HScore may enhance the coding accuracy of COPD exacerbations in newly diagnosed patients. Further data points are needed to robustly evaluate its long-term effectiveness on broader clinical outcomes.
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