在耐药患者中使用推的神经诊断评估
Matthew Spotnitz1, Cameron D Ekanayake2, Anna Ostropolets1
1Department of Biomedical Informatics, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York.
JAMA neurology
|April 1, 2024
概括
患有耐药性 (DRE) 的患者通常不会接受推的神经诊断评估. 根据护理环境和保险类型,评估率有很大差异,这突显了最佳实践遵守的差距.
科学领域:
- 神经学 神经学
- 的研究研究.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 跨学科的指导方针建议对耐药性进行全面的神经诊断评估.
- 专业中心报告DRE手术前评估的延迟和使用不足.
- 在美国不同环境中对DRE神经诊断评估的纵向数据有限.
研究的目的:
- 确定DRE患者的神经诊断研究和综合评估的速度.
- 确定与在不同美国医疗保健机构中接受这些评估相关的因素.
主要方法:
- 使用观察医学结果伙伴关系共同数据模型进行回顾性横截面研究.
- 包括美国医疗补助,商业索赔和电子健康记录数据 (哥伦比亚大学医学中心).
- 分析的患者在2015-2020年期间满足了DRE可计算的表型算法.
主要成果:
- 综合评估率很低:医疗补助 (4.5%),商业 (8.0%) 和CUMC (14.3%).
- 视频脑电图和MRI脑部比神经心理评估或高级成像更为常见.
- 不紧急探和焦点的更高频率与评估率的增加有关.
结论:
- 对于DRE患者使用推的诊断研究存在重大差距.
- 护理环境,保险类型,访问频率和类型影响评估率.
- 共同的数据模型可以在各种数据源中跟踪对最佳实践的遵守.
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