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Updated: Jun 10, 2025

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积极选择推动在高风险患者中增加对原发性阿尔多斯特主义的查
Jesse E Passman1,2, Jasmine Hwang1,2, Justin Tang3
1From the Department of Surgery (Passman, Hwang, Wachtel), University of Pennsylvania Health System, Philadelphia, PA.
Journal of the American College of Surgeons
|October 21, 2024
概括
原发性阿尔多斯特龙性 (PA) 查是不常见的. 基于电子健康记录 (EHR) 的推动在试点研究中显著增加了PA查率,这表明了改善检测的可行方法.
科学领域:
- 内分泌学 在内分泌学.
- 高血压管理 高血压管理
- 医疗信息学 医疗信息学
背景情况:
- 主要的阿尔多斯特主义 (PA) 是二次高血压的最常见原因.
- 目前在临床实践中,对PA的查尚未得到充分利用.
- 改善PA查对于及时诊断和治疗至关重要.
研究的目的:
- 评估大型卫生系统内的PA查实践.
- 开发一个可计算的表型来识别符合条件的PA查候选人.
- 设计和试点一个基于电子健康记录 (EHR) 的推动力,以促进PA查.
主要方法:
- 一个多学科团队使用EHR工具和主动选择推动开发了一个干预措施.
- 一个可计算的表型被改进,以识别患有PA更高可能性的患者.
- 一项试点研究比较了干预和非干预初级保健诊所7个月的查频率.
主要成果:
- 基线PA查频率低,为1.4%.
- 与更高查概率相关的因素包括高血压,更多的药物,较低的,专家护理和黑人种族.
- 精制的表型确定了一个高风险的亚队列 (8.6%对4.1%的阳性查).
- 基于电子健康记录的推动显著增加了查率 (16.4%与试点诊所的1.8%相比).
结论:
- 目前的PA查率是不充分的.
- 基于EHR的nudge,利用精确的可计算表型,可以大大提高适当的PA查.
- 这种方法有望改善PA诊断和患者的治疗结果.
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