在大数据库中检测尾炎延迟诊断的方法的社区验证
Kenneth A Michelson1, Finn L E McGarghan1, Mark L Waltzman1
1Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachussetts.
Hospital pediatrics
|June 4, 2023
概括
一种新方法有效地使用行政数据在社区急诊室 (ED) 检测尾炎的延迟诊断. 这种经过验证的触发工具识别了高风险的医疗保健环境,以改善患者的治疗结果.
科学领域:
- 儿科急救医学 儿科急救医学
- 医疗保健服务研究 医疗服务研究
- 诊断的准确性 诊断的准确性
背景情况:
- 延迟诊断可能会对患者的结果产生负面影响.
- 对于儿童医院来说,已经存在一种验证的检测诊断延迟的方法.
- 需要在社区急诊室 (ED) 进行进一步的验证.
研究的目的:
- 验证先前开发的触发工具,用于检测社区EDS中尾炎的延迟诊断.
- 通过使用行政数据来评估工具的性能.
- 确定诊断延迟风险较高的医疗保健机构.
主要方法:
- 在8个马萨诸塞州东部ED中,对在2008-2019年期间被诊断患有尾炎的21岁以下患者进行了回顾性研究.
- 纳入标准:在7天内有2次ED接触,第二次接触时诊断为尾炎.
- 应用一个经过验证的触发工具,使用行政数据 (诊断,遭遇时间,医疗复杂性,停留时间) 和手动医疗记录审查.
主要成果:
- 分析包括68名患有可能诊断延迟的儿童.
- 触发工具在信任值中显示出高的积极预测值 (74%-92%).
- 接收器操作曲线下的面积为0.837,表明良好的区分能力.
结论:
- 使用行政数据的触发工具有效地识别了社区ED的延迟诊断.
- 该工具在检测真正的诊断延迟方面显示出高的积极预测值.
- 这种方法适用于社区ED设置,以提高诊断的及时性.
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