在放射治疗期间通过机器学习指导的评估来降低医疗保健成本 - - 一项随机对照研究的经济分析
Divya Natesan1,2, Eric L Eisenstein3, Samantha M Thomas4,5
1Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC.
NEJM AI
|April 8, 2024
概括
机器学习 (ML) 识别了放射治疗 (RT) 的高风险患者,他们从补充评估中受益. 这种以ML为导向的干预措施显著减少了急性护理利用率和总医疗成本,证明了成本有效的医疗保健.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 医疗信息学 医疗信息学
背景情况:
- 机器学习 (ML) 可以通过识别患者进行预防性干预来优化医疗保健.
- 在SHIELD-RT研究中,ML用于在放射治疗 (RT) 期间识别高风险患者进行补充评估.
- 这种干预措施成功地减少了急性护理的利用率.
研究的目的:
- 在SHIELD-RT研究中对ML导向干预进行经济分析.
- 确定使用ML用于针对高风险RT患者的补充临床评估的成本效益.
主要方法:
- 对SHIELD-RT随机对照试验进行了后期经济分析.
- 通过ML确定的高风险患者被随机分配到标准护理或每周两次的强制性评估中.
- 总医疗费用,包括急性护理和干预费用,使用负二项式回归分析.
主要成果:
- 干预组的急性护理访问减少 (0.31比0.47每疗程,P=0.04).
- 干预组的总平均调整成本显着较低 (每课程1494美元和3110美元,P=0.03).
- 在干预组中,额外的评估费用为每门课程155美元.
结论:
- 强制性补充评估对ML识别的高风险患者降低了总医疗费用,改善了临床结果.
- 以ML为导向的干预表明,在RT期间管理高风险患者的成本效益高的方法.
- 需要进一步的研究来证实这些经济发现的概括性.
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