验证了一种用于识别急诊室狂妄症的图表检查方法
Piayeng Thao1, Kayla P Carpenter2, Annelise S Howick2
1Department of Emergency Medicine, Mayo Clinic, Rochester, MN, USA; University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA.
基于图表的 Delirium 识别仪器 (CHART-DEL) 显示出在急诊室 (ED) 进行回顾性 Delirium 检测的前景. 虽然在识别没有妄想症的患者方面是有效的,但需要进一步开发以提高其在检测妄想症患者中的准确性.
科学领域:
- 老年医学 老年医学
- 紧急医疗 紧急医疗
- 精神病学是一个精神病学.
背景情况:
- 痴呆症是老年人向急诊室 (ED) 提出的常见和严重的疾病.
- 在ED中准确及时识别痴呆症对于适当的管理和改善患者结果至关重要.
- 现有的妄想选工具在快节奏的ED环境中可能存在局限性.
研究的目的:
- 验证基于图表的 Delirium 识别仪器 (CHART-DEL),用于在急诊室 (ED) 识别75岁及以上患者的 Delirium.
- 评估CHART-DEL工具在追溯应用到ED病历时的准确性和可靠性.
主要方法:
- 一项追溯观察性研究,涉及2021年至2023年期间75岁以上患者的27,082次ED访问.
- 患者最初使用两步工具 (迷妄分辨屏和简要混评估方法) 选迷妄.
- 使用CHART-DEL方法审查了600份医疗记录的分层随机样本,并计算了评估者间的协议和诊断测试准确性.
主要成果:
- 在加权时,CHART-DEL工具在确定ED患者群体中的痴呆症的总准确率为86.4%.
- 检测狂妄症的灵敏度为74.2%,特异性为87.0%.
- 该工具在正确识别没有妄想症的患者方面表现更好 (特异性为87.0%),而不是妄想症患者 (灵敏度为74.2%).
结论:
- 该CHART-DEL仪器适用于急诊室设置以追溯检测妄想.
- 该工具显示了改进回顾性妄想识别和支持未来临床查应用的潜力.
- 可能需要进一步细化,以优化CHART-DEL的灵敏度,以检测ED中的妄想.
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