基于电子医疗记录的新型自动化VEST (虚拟心声扫描查工具) 算法用于肺动脉高血压
Suneesh Chembiparambil Anand1, Gabriela Narowska2, Chethan Gangireddy3
1Division of Cardiology, Advanced Pulmonary Hypertension, Right Heart Failure, CTEPH Program, Temple University Lewis Katz School of Medicine & Temple University Hospital, Philadelphia, PA.
一个自动化的电子病历 (EMR) 工具准确计算虚拟心声扫描查工具 (VEST) 评分,以识别肺动脉高血压 (PAH) 患者,改善及时转诊到专业护理.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 医疗信息学 医疗信息学
背景情况:
- 肺动脉高血压 (PAH) 往往由于非特异性症状和推迟转诊而被诊断不足.
- 虚拟心声扫描查工具 (VEST) 是一种验证的方法,用于预测PAH血液动力学.
- 认可的肺高血压 (PH) 中心对于及时诊断和治疗至关重要.
研究的目的:
- 评估基于自动化电子病历 (EMR) 的算法来计算VEST分数.
- 为了确定自动化VEST得分是否可以准确地识别患有PAH的患者.
- 评估算法在促进转诊到PH专科护理方面的实用性.
主要方法:
- 对4952名患者进行了回顾性分析,这些患者的胸前心声图 (TTE) 和三回速度 (TRV) ≥2.9 m/s.
- 自动计算的EMR计算的VEST得分与手动计算的VEST得分的比较.
- 识别高风险患者 (VEST+3分) 以进一步分析转诊和诊断途径.
主要成果:
- 自动化EMR VEST得分显示与手动计算的相关性为100%.
- 接受右心导管治疗 (RHC) 的+3VEST得分的患者表现出严重的PH (平均PAP为48mmHg,PVR为8.5木单元).
- 很大一部分高风险患者 (29.4%) 没有被转诊到专业PH护理,只有37.5%接受RHC.
结论:
- 基于EMR的自动VEST计算器有效地识别出患有PAH高风险的患者.
- 这种工具可以促使早期诊断和转介到认可的PH中心.
- 促进早期的专家护理和PAH患者的医疗治疗开始.
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