在中风装置设置中的心房动检测的数据库启用质量控制
Mario E Andina1, Alexander Nelde1, Christian H Nolte1,2,3,4
1Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Heliyon
|August 3, 2023
概括
在中风患者中,自动心房动 (AF) 报警是有效的,但需要临床团队对错过诊断进行审查. 改善AF检测可以加强二次预防策略.
科学领域:
- 心脏病学和神经病学
- 医疗信息学 医疗信息学
- 临床试验方法论 临床试验方法论
背景情况:
- 心房动 (AF) 是急性中风患者的常见并发症.
- 持续监测AF对于及时诊断和治疗至关重要.
- 用于AF报警的标准操作程序 (SOP) 需要在临床实践中进行验证.
研究的目的:
- 在临床实践中评估心房动 (AF) 报警标准操作程序 (SOP) 的准确性.
- 评估住院急性中风患者自动连续AF监测的性能.
- 为了确定错过的AF诊断及其对抗凝血剂治疗启动的影响.
主要方法:
- 追溯队列研究涉及109名急性缺血性中风患者,有AF报警.
- 围绕AF警报的ECG数据段从临床数据仓库下载.
- 手动审查将心电图段分类为AF,非AF或文物;数据与电子健康记录进行交叉引用.
主要成果:
- 在3.7%的患者中,尽管出现了真正的积极警报,但临床团队错过了AF.
- 所有错过AF诊断的患者都没有接受抗凝药治疗.
- 自动AF检测系统的正预测值 (PPV) 为0.6.
结论:
- 自动化AF监控系统是有效的,但需要临床团队的监督,以防止错过诊断.
- 在中风治疗期间检测AF的既定SOP是有效的,但提供了改进的机会.
- 数据仓库集成的方法可以提高AF监控质量,并确定过程优化的领域.
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