关于儿童喘恶化风险的供应商预测模型的有效性:差异分析中的差异分析
Avinash Murugan1, Swaminathan Kandaswamy2, Edwin Ray3
1Department of Medicine, Yale New Haven Hospital, New Haven, Connecticut, United States.
Applied clinical informatics
|September 29, 2023
概括
一个电子健康记录 (EHR) 模型减少了儿科喘住院和急诊室的访问. 这种预测工具有助于量身定制喘疗法,改善患有喘的儿童的治疗结果.
科学领域:
- 儿科肺病学 儿科肺病学
- 医疗信息学 医疗信息学
- 临床决策支持 临床决策支持
背景情况:
- 喘是儿童疾病和死亡的重要原因之一.
- 预测模型可以根据恶化风险个性化喘治疗.
- 喘风险评分对临床实践和儿科结果的影响尚不清楚.
研究的目的:
- 评估电子健康记录 (EHR) 供应商开发的模型在改善喘儿童的治疗结果方面的有效性.
主要方法:
- 为志愿服务提供者实施了Epic系统儿童喘恶化风险模型.
- 在实施前和之后 (2021年2月至2022年2月) 的差异设计比较了结果 (住院治疗,急救诊所访问,口服类固醇课程).
- 定性访谈探讨了提供者与模型的经验.
主要成果:
- 在干预组中,90天内喘住院病例从1.4%降至0.7% (调整后的差异差异: -0.9%).
- 在干预组中,急诊室的访问减少了2.4%.
- 在口服类固醇疗程中没有观察到显著的变化.
结论:
- 这种EHR供应商模型的实施与儿童的喘住院和急救诊所的减少有关.
- 该模型被提供者认为是有用的,尽管临床判断仍然是关键.
- 可能需要进一步的研究来优化其对所有喘相关结果的影响.
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