预测扩展咨询对多病症个性化护理的预期好处:一般实践中优先级算法的开发和内部验证研究
Mieke Jl Bogerd1, Collin Jc Exmann1, Pauline Slottje1
1Department of General Practice, Amsterdam UMC, Vrije Universiteit Amsterdam, and Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
这项研究开发了一个使用电子医疗记录数据的算法,以识别具有多病症的患者,他们将从以人为中心的护理中获益最多. 该工具有助于全科医生优先考虑需要延长咨询的患者,改善慢性疾病管理.
科学领域:
- 一般实践 一般实践
- 医疗保健服务研究 医疗服务研究
- 慢性疾病管理 慢性疾病管理
背景情况:
- 患有多病症的人可以从以人为中心的护理中受益,而不是从当前的慢性疾病管理中受益.
- 由于时间和资源的限制,优先考虑患者以人为中心的慢性护理至关重要.
研究的目的:
- 使用电子医疗记录 (EMR) 数据开发和验证优先级算法.
- 区分多病症患者谁会从一个扩展的人为中心的咨询中受益.
主要方法:
- 在五个荷兰一般实践中进行混合方法研究.
- 多变量后勤回归和重点小组的主题分析.
- 使用十倍交叉验证进行内部验证.
主要成果:
- 分析了1032名患者的EMR;34.1%的预期好处.
- 模型实现了0.72.7的交叉验证C统计值.
- 家庭访问和心肌梗塞病史预测了益处;医生关注,患者心态和护理平衡是关键因素.
结论:
- 该算法可以自动对多病症患者进行优先排序.
- 减少了全科医生手动分组所有此类患者的需要.
- 在实施之前,建议对实际咨询效益进行外部验证和评估.
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