在初级保健中识别脆弱性:电子衍生措施的准确性
Karin Ma Swart1, Amber Awa van der Heijden2, Marieke T Blom2
1PHARMO Institute for Drug Outcomes Research, Utrecht, and Amsterdam UMC location Vrije Universiteit Amsterdam, General Practice, Amsterdam, the Netherlands.
概括
电子医疗记录可以识别老年人的脆弱性. 查尔森并发症指数 (CCI) 显示出最佳表现,尽管在老年人群中准确性下降.
科学领域:
- 老年学是一门学科.
- 初级医疗保健医学 一级医疗保健医学
- 医疗信息学 医疗信息学
背景情况:
- 从电子医疗记录 (EMR) 中例行收集的临床数据为定义脆弱性提供了潜在的资源.
- 在初级保健中评估脆弱性对于管理老年人至关重要.
研究的目的:
- 评估四个基于EMR的脆弱性指标的准确性,以确定一般医生 (GPs) 确定的脆弱老年患者.
主要方法:
- 这是一项回顾性队列研究,利用了来自36个荷兰GP实践的数据.
- 我们比较了四种脆弱性指标:荷兰多药学指数,查尔森并发症指数 (CCI),慢性疾病得分 (CDS) 和脆弱性指数.
- 使用接收器操作特征曲线 (AUC) 下面的面积来评估性能,将GP的临床判断作为参考标准.
主要成果:
- 在31511名65岁或以上的患者中,11.9%被全科医生认定为虚弱.
- CCI显示了最高的AUC (0.79),其次是CDS (0.69).
- 在85岁以上的患者中,所有测量指标的性能都显著下降.
结论:
- 查尔森并发症指数 (CCI) 是基于EMR的最准确的脆弱性测量方法,在初级保健中评估的四种方法中最准确.
- 虽然在年轻的老年人中是可以接受的,但这些措施的诊断性能在老年人群中是有限的,这阻碍了它们对最脆弱的人群的有用性.
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