在心力衰竭中与种族和种族相关的差异与使用自然语言处理保存的喷射分数
Sam Brown1,2, Dhruva Biswas1,2, Jack Wu2
1King's College Hospital NHS Foundation Trust, London, United Kingdom.
JACC. Advances
|July 25, 2024
概括
已确定的心力衰竭与保留喷射分数 (HFpEF) 诊断工具在黑人患者中低估了HFpEF的诊断. 这很可能是由于并发症模式的差异,突出了在不同人群中改善诊断方法的需要.
科学领域:
- 心脏病学 心脏病学
- 医疗信息学 医疗信息学
- 健康 公平 卫生 公平
背景情况:
- 保存喷射分数 (HFpEF) 的心力衰竭是老年人心力衰竭的最常见类型.
- HFpEF是一种异质综合征,在不同种族之间理解有限.
- 对HFpEF的临床表现和诊断工具性能的种族差异没有得到很好的描述.
研究的目的:
- 为了在不同种族群体中比较HFpEF的临床表现.
- 评估现有的HFpEF诊断工具在不同种族的诊断性能.
- 在HFpEF诊断中识别潜在的健康不平等.
主要方法:
- 一个自然语言处理 (NLP) 算法分析了伦敦一家医院的电子健康记录.
- 确定了符合欧洲心脏病学会HFpEF标准的患者.
- 关于人口统计,并发病,生物标志物 (NT-proBNP),H2FPEF得分和心声回声图的数据被提取并按种族分层.
主要成果:
- 该队列包括1,261名白人,578名黑人和134名亚洲患者.
- 黑人患者在诊断时比白人患者年轻,代谢并发病率 (肥胖,糖尿病,高血压) 比白人患者高.
- 与白人患者相比,黑人患者的NT-proBNP水平较低,H2FPEF得分的频率较低,表明HFpEF.
结论:
- 基于NLP的AI使用既有标记在黑人患者中识别了HFpEF的系统性低诊断.
- 伴随性疾病模式的差异可能解释了黑人患者的诊断不足.
- 临床医生必须认识到这些诊断局限性及其对治疗和临床试验招聘的影响.
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