患有阿片类药物相关疾病的患者向急诊室呈现的计算表型
R Andrew Taylor1,2,3, Aidan Gilson1, Wade Schulz3,4
1Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America.
PloS one
|September 15, 2023
概括
这项研究使用电子健康记录确定了九个不同的患者群体,他们使用阿片类药物相关的急诊室 (ED) 访问了电子健康记录. 这些表型显示出不同的结果,指导针对阿片类药物使用障碍和过量服用的有针对性的干预措施.
科学领域:
- 计算流行病学计算流行病学
- 医疗信息学 医疗信息学
- 在医疗保健中的数据科学.
背景情况:
- 与阿片类药物相关的疾病在紧急护理中提出了复杂的挑战.
- 了解患者异质性对于有效的治疗策略至关重要.
研究的目的:
- 从临床笔记和电子健康记录 (EHR) 来计算出患者的表型,用于与阿片类药物相关的急诊室 (ED) 访问.
- 根据这些衍生的表型,识别不同的患者队列.
主要方法:
- 追溯分析了82,577次 (2013-2020年) 患有阿片类药物相关诊断的患者的ED访问.
- 在EHR数据上利用自然语言处理 (NLP) 和潜在的迪里克莱特分配 (LDA) 来识别患者演示主题.
- 应用集群分析,将类似的患者表现分组为不同的队列.
主要成果:
- 发现了与物质使用,慢性疾病,心理健康和医疗管理相关的30个主题.
- 确定了9个独特的患者队列,一年的结果各不相同:生存率 (84.2-96.8%),ED复发率 (9-34%),阿片类事件 (10-17%),阿片类使用障碍 (MOUD) 药物治疗率 (17-43%).
- 现型群包括与慢性物质使用障碍和急性过量服用有关的群体.
结论:
- 确定了具有差异性患者结果的明显的表型群.
- 这些发现凸显了与阿片类药物相关的ED访问患者的异质性.
- 针对特定患者群体需要有针对性的资源配置和治疗干预措施.
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