在老年患者中设计和验证糖尿病脏保护的临床决策支持算法
Noor Alsalemi1,2, Cheryl Sadowski3, Naoual Elftouh4
1College of Pharmacy - Clinical Pharmacy and Practice, Qatar University, Doha, Qatar.
BMJ health & care informatics
|August 29, 2024
概括
这项研究开发了一种临床决策支持 (CDS) 算法,以个性化对糖尿病病 (DKD) 的老年人进行氨酸- ангиотензин- 阿尔多素系统抑制剂 (RAASi) 处方. 该算法旨在通过将患者特定因素纳入处方决策来改善治疗.
科学领域:
- 老年医学 老年医学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 药理学 药理学是指药理学的学科.
背景情况:
- 患有糖尿病病 (DKD) 的老年人经常接受低于最佳的药理治疗.
- 目前的临床实践指南 (CPG) 缺乏针对这一群体的个性化护理整合.
- 临床决策支持 (CDS) 工具可以通过将证据与个性化护理相结合来提高患者的治疗结果.
研究的目的:
- 设计和验证一个CDS算法,以优化老年糖尿病患者的氨酸- ангиотензин- алдостерон系统抑制剂 (RAASi) 处方.
- 为了弥补现有的 DKD 管理的 CPG 中个性化护理的差距.
主要方法:
- 系统审查和元分析确定了需要治疗的数量 (NNT) 和时间到效益 (TTB) 值.
- 开发了RAASi处方的临床场景.
- 与临床病例相匹配的NNT和TTB值,包括患者的预期寿命和功能能力.
- 该CDS算法经过了使用Delphi技术与专家审查的验证.
主要成果:
- 创建了一个全面的CDS算法,解决了15个不同的处方场景.
- 算法产生了36个个性化和9个一般性建议.
- 通过三轮Delphi研究的专家验证证实了算法的实用性.
结论:
- 一个基于证据的CDS算法被成功设计,整合了个性化护理的考虑因素,这些考虑因素在CPG中经常被遗漏.
- 开发的算法代表了向改善RAASi处方对DKD的老年人的重要一步.
- 未来的临床试验计划在现实环境中测试这种CDS算法的有效性.
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