使用创新的IT解决方案,在全科医院对晚期慢性肝病的患者进行查:肝脏工具包
David S Prince1,2,3,4, Shakira Hoque5, Christy Kim5
1AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Hepatology communications
|June 27, 2024
概括
一个新的IT系统有效地选了超过32,000名初级保健患者的晚期慢性肝病 (ACLD). 在召回的5名患者中,有超过1名被诊断患有肝病,这突显了该系统在早期检测方面的成功.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 公共卫生 公共卫生
- 医疗信息学 医疗信息学
背景情况:
- 识别未诊断的晚期慢性肝病 (ACLD) 患者是一个重大的公共卫生挑战.
- 对于晚期纤维化或补偿性肝硬化患者的早期干预可以改善结果并预防疾病的进展.
研究的目的:
- 开发和评估基于云的软件解决方案,肝脏工具包,用于识别初级保健机构中患有ACLD风险的患者.
- 评估肝脏工具包在召回高危患者和使用非侵入性方法诊断ACLD方面的有效性.
主要方法:
- 一个基于云的软件 (肝脏工具包) 访问了初级保健记录,以提取临床病史和实验室结果.
- 计算了阿斯巴酸氨基转移酶与血小板比率指数和纤维化4分数,以识别有风险的患者.
- 通过过渡性弹性图谱进行肝硬度测量 (LSM) 的患者被召回,不包括现有肝硬化诊断的患者.
主要成果:
- 超过32,000名成年人进行了查,确定了703名患者 (2.2%) 患有ACLD的风险增加.
- 在179名被召回的患者中,23人 (13%) 被诊断为ACLD (LSM ≥10.0 kPa),代谢功能障碍相关的脂肪性肝病是最常见的病因.
- 对ACLD检测的积极预测值为19%的AST与血小板比率指数≥1.0和24%的纤维化-4≥3.25.
结论:
- 肝脏工具包成功选了大量的初级保健队列,使用现有的实验室数据来识别患有ACLD风险的患者.
- 超过20%的被召回患者被发现患有需要专家随访的肝病,证明了该系统的临床实用性.
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