开发一个电子患者安全监测模型,以有效地识别胃肠内镜的潜在不良事件
Brian A Sullivan1, Marva V Foster2, Andrew Hwang3
1Department of Medicine, Division of Gastroenterology, Duke University School of Medicine, Durham, North Carolina, USA; Cooperative Studies Program Epidemiology Center-Durham, Durham VA Health Care System, Durham, North Carolina, USA.
开发了一种电子监测模型,用于在胃肠道内镜检查后识别不良事件 (AE). 这种工具有效地标志着潜在的患者伤害,提高了常规胃肠道手术的安全性和质量改善.
科学领域:
- 胃肠病学 胃肠病学
- 医疗信息学 医疗信息学
- 患者安全 患者安全
背景情况:
- 建议在消化道内镜检查后跟踪不良事件 (AE),但很难.
- 需要电子监控模型来系统地识别AE.
研究的目的:
- 开发和验证一种电子监测模型,用于识别具有可能的AE的门诊肠道内镜.
- 系统地识别患者在胃肠道手术后的伤害.
主要方法:
- 在退伍军人卫生管理局 (2018-2020年) 评估了门诊GI程序.
- 定义了与内镜相关的副作用,并使用电子触发器来开发监控模型.
- 在独立图表审查样本 (2021-2022) 上验证了模型.
主要成果:
- 该模型标记了1.2%的肠道内镜,在最佳值处具有潜在的副作用.
- 在验证中,正的预测值为69.6%,假负率为26.0%.
- 该模型显示了AE识别与图表审查负担之间的灵活性.
结论:
- 一个电子AE监控模型有效地识别高风险的GI内镜病例.
- 该工具补充了现有的AE监测策略,并提高了患者的安全性.
- 该模型的可适应值优化了AE检测或最大限度地减少了审查工作量.
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