完善临床表型以改善临床决策支持和减少警觉疲劳:一个可行性研究
Lipika Samal1,2, Edward Wu1,3, Skye Aaron1
1Department of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States.
Applied clinical informatics
|July 12, 2023
概括
开发可计算的表型 (CP) 和估计警报负担有助于优化慢性病 (CKD) 和高血压 (HTN) 管理的计算机化临床决策支持 (CDS).
科学领域:
- 医疗信息学 医疗信息学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 主要护理医学 医疗保健
背景情况:
- 慢性病 (CKD) 很普遍,并且与糟糕的结果有关.
- 初级保健医生 (PCP) 管理早期的CKD和高血压 (HTN).
- 计算机化临床决策支持 (CDS) 可以增强CKD护理,但可能会引起疲劳.
研究的目的:
- 评估实施CDS警报用于CKD和HTN管理的可行性.
- 开发可计算的表型 (CPs) 来识别有风险的患者群体.
- 估计PCP的潜在警报负担.
主要方法:
- 根据临床指南开发了五个CP,用于3-4期CKD和不受控制的HTN.
- 采用了数据分析,验证和专家审查的代过程来改进CP.
- 估计潜在的警报频率,限制每名患者一次的警报.
主要成果:
- 确定了9,081名患有3-4期CKD的患者 (8.6%) 和4,191名患有不受控制的HTN.
- 估计有5369个潜在的警报,如果没有限制,平均每周0.07-0.17个PCP警报.
- 描述CKD人口主要为女性,老年人,白人和英语使用者.
结论:
- CP开发和警报负担估计使得CDS可以进行代的改进.
- 这种方法有助于平衡护理标准化与PCP警报疲劳的风险.
- 促进关于CDS实施的知情决策,以改善CKD和HTN管理.
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