差分分布:通过根据相关的ICD-10代码包括患者的健康状况来评估间接参考区间的精细方法
David Schär1, Tobias U Blatter1,2, Harald Witte1
1University Institute of Clinical Chemistry Inselspital - Bern University Hospital and University of Bern, Switzerland.
Practical laboratory medicine
|July 21, 2025
概括
差分分布法 (DDM) 通过使用ICD-10代码来细化参考间隔 (RIs),以考虑患者的健康状况,提高诊断准确性和识别多病症.
科学领域:
- 临床化学 临床化学
- 医疗信息学 医疗信息学
- 数据挖掘 数据挖掘
背景情况:
- 传统的参考区间 (RI) 估计方法通常不考虑患者的健康状况而排除患者数据.
- 这种排除导致了对准确的RI确定有价值的信息的丢失.
研究的目的:
- 引入和验证差分分布方法 (DDM) 以生成更准确,更健康的参考间隔.
- 利用与ICD-10代码相关的实验室常规数据来改善患者分层.
主要方法:
- 差分分布方法 (DDM) 使用ICD-10编码的实验室数据来识别和排除具有不同健康状况的子群体.
- 这种方法从混合的临床数据中估计出一个非患病的,年龄和性别分层的人口.
- 然后根据年龄和性别分层生成参考间隔,并将患者的健康信息纳入其中.
主要成果:
- 在不同患者群体中,DDM成功地调整了血水平的参考间隔.
- 该方法揭示了老年人 (60岁以上) 的显著变化和更紧密的置信区间.
- 参考间隔随着年龄的增长而略有扩大,标准偏差由于删除与特定ICD-10代码相关的异常数据而减少.
结论:
- DDM提供了一个强大的数据挖掘框架,用于参考区间推断.
- 调整后的RI结合了ICD-10代码中的临床细微差别,提高了诊断准确度.
- 该方法有助于识别影响实验室结果的潜在多病症.
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