将机器学习驱动因素纳入电子触发器的设计,以检测紧急部门的诊断错误
Moein Enayati1,2, Mahsa Khalili1,3, Shrinath Patel1
1Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota.
Journal of patient safety
|September 24, 2025
概括
机器学习 (ML) 模型略有改进了基于电子健康记录 (EHR) 的触发器,用于识别急诊部 (ED) 的诊断错误. 确定了新的因素,为更准确的诊断错误检测系统铺平了道路.
科学领域:
- 医疗信息学 医疗信息学
- 医疗保健中的人工智能
- 患者安全 患者安全
背景情况:
- 基于电子健康记录 (EHR) 的触发器 (eTriggers) 用于检测急诊部 (ED) 的诊断错误.
- 当前的eTriggers通常表现不佳,因此需要改进准确识别错误的方法.
研究的目的:
- 调查多因素机器学习 (ML) 方法的增量值.
- 提高eTriggers的性能,用于识别ED中的诊断错误.
主要方法:
- 使用标准定义,将124,053例ED遭遇分为触发性阳性和触发性阴性 (ED复诊,住院到ICU升级,24小时内死亡).
- 在平衡和不平衡数据集上训练和评估了6个监督的ML模型.
- 在临床注释数据和基于触发器的标签上训练的模型进行了比较.
主要成果:
- 标准触发器显示出较低的积极预测值 (PPV):5.2% (T1),8.2% (T2),6.5% (T3).
- 在不平衡的测试集上使用ML模型的性能很低 (PPV:0.00-0.16).
- 在平衡测试组 (PPV:0.82-1.00) 中,ML模型在临床注释数据显示额外的因素方面实现了更高的性能.
结论:
- 电子触发器的机器学习改进为诊断错误识别提供了轻微的改进,由PPV的增加表明.
- 确定了导致ED诊断错误的新潜在因素.
- 研究结果表明,可以开发更准确的电子触发器来检测诊断错误.
相关概念视频
Documentation of Nursing Diagnosis
1.6K
The nurse documents nursing diagnoses and enters them into the patient record. The identified patient's nursing diagnosis is either written out with a plan of care or entered into the electronic health record.
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters...
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters...
1.6K
Errors occurring during blood pressure monitoring
1.3K
Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
Several factors...
1.3K
Methods of Documentation VII: EMR
1.4K
Electronic Medical Records (EMRs) primarily center around electronically documenting patients' health information within a single healthcare organization or practice. They contain essential clinical data related to a patient's medical history, diagnoses, medications, treatment plans, lab results, and other pertinent information relevant to the specific encounter or episode of care. EMRs are designed to streamline documentation and workflow processes within individual healthcare...
1.4K
Cardiopulmonary Resuscitation III: AED Use
547
Introduction to AEDAn Automated External Defibrillator (AED) is a portable medical device that analyzes the heart's rhythm and, if necessary, delivers an electrical shock to help the heart re-establish an effective rhythm during sudden cardiac arrest (SCA). SCA occurs when the heart suddenly and unexpectedly stops beating, leading to a loss of blood flow to the brain and other vital organs. In such emergencies, time is of the essence, and using an AED, combined with Cardiopulmonary...
547
Pulse rhythm
1.3K
Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
1.3K
Types of Errors: Detection and Minimization
10.2K
Error is the deviation of the obtained result from the true, expected value or the estimated central value. Errors are expressed in absolute or relative terms.
Absolute error in a measurement is the numerical difference from the true or central value. Relative error is the ratio between absolute error and the true or central value, expressed as a percentage.
Errors can be classified by source, magnitude, and sign. There are three types of errors: systematic, random, and gross.
Systematic or...
Absolute error in a measurement is the numerical difference from the true or central value. Relative error is the ratio between absolute error and the true or central value, expressed as a percentage.
Errors can be classified by source, magnitude, and sign. There are three types of errors: systematic, random, and gross.
Systematic or...
10.2K


