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在临床决策中使用患者报告的症状数据规则,在远程医疗环境中预测流感

W Zane Billings¹, Annika Cleven¹, Jacqueline Dworaczyk¹

¹From the Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA (WZB, APD, ME, AH); Department of Mathematics, St. Olaf College, Northfield, MN (AC); Ira A. Fulton Schools of Engineering, Arizona State University, Tempe, AZ (JD); Department of Family and Consumer Sciences, University of Georgia, Athens, GA (BM).

Journal of the American Board of Family Medicine : JABFM

|September 29, 2023

概括

患者和临床医生的症状报告分歧降低了流感诊断规则的准确性. 使用患者数据的新模型的表现稍差一些,这凸显了对远程医疗诊断进一步研究的需要.

科学领域:

传染病流行病学传染病流行病学
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:

远程医疗为简化流感诊断和减少流感传播提供了潜力.
准确的患者症状报告对于基于远程医疗的诊断至关重要.
患者和临床医生的症状报告之间的差异可能会影响诊断规则的准确性.

研究的目的:

评估患者与临床医生的症状报告对流感诊断规则表现的影响.
使用两种数据源,比较先前开发的临床决策规则 (CDR) 的准确性.
根据患者报告的症状,开发和评估新的预测模型.

主要方法:

在大学学生健康中心进行前性队列研究的二次分析.
对上呼吸道疾病患者报告和临床医生报告的症状进行比较.
使用两种症状数据集对现有的5种流感CDR与PCR诊断进行评估.
使用患者报告的症状数据开发新的预测模型.

主要成果:

与临床医生报告的症状相比,与患者报告的症状相比,临床决策规则的表现始终较低.
症状报告中的分歧导致同一个人的流感预测不同.
使用患者报告数据的新开发模型与现有的CDR相比,性能略有下降.
基于患者和临床医生的模型都表现出校准问题.

结论:

患者和临床医生之间关于症状存在的频繁分歧降低了CDRs的准确性.
基于患者报告的症状的预测模型与使用临床医生数据的模型相比表现不佳.
虽然差异很小,但进一步开发更多数据的模型可能会改善远程医疗流感诊断.

关键词:

临床决定规则临床决策规则群组研究群组研究传染性疾病传染性疾病流感是一次流感.展望研究未来研究呼吸道疾病呼吸道疾病学生学生学生学生学生远程医疗远程医疗测量三级是什么意思

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