在初级保健中利用临床决策支持系统对机会性慢性病查进行试点研究
Maite López-Garrigós1,2,3,4, Estanislao Puig5, Selene Sánchez5
1Clinical Laboratory, Hospital Universitario de San Juan, 03550 San Juan de Alicante, Spain.
Diagnostics (Basel, Switzerland)
|January 10, 2026
概括
在初级保健中使用临床决策支持系统 (CDSS) 的机会性查有效地识别了新的慢性病 (CKD) 病例. 这种低成本的方法可以进行早期干预,有可能减缓疾病的进展,减少心血管事件.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 初级医疗保健医学 一级医疗保健医学
- 医疗信息学 医疗信息学
背景情况:
- 慢性病 (CKD) 影响超过10%的成年人,由于无症状的进展,往往未被诊断出来.
- 在初级保健中通过机会性查进行早期检测对于及时干预至关重要.
- 临床决策支持系统 (CDSS) 可以促进有效的查,使患者负担最小.
研究的目的:
- 评估 CDSS 支持的 CDD 的可行性,诊断产量,临床行动和成本,在初级保健中对 CKD 进行白色素蛋白尿第一个查计划.
- 评估将CDSS与常规实验室检测用于CKD检测的有效性.
- 确定新发现的CKD病例的比例及其KDIGO风险分层.
主要方法:
- 一个为期一年的横截面干预选了符合条件的初级保健患者 (60-85岁或18-59岁的并发症患者) 使用CDSS.
- 该CDSS整合了患者数据和指导规则,以促使尿蛋白和eGFR测试.
- 异常结果引发了确认性测试,结果包括诊断产量,风险分层,转诊和试剂成本.
主要成果:
- 在7722名目标患者中,1774人完成了查,确定了104例新的CKD病例 (5.9%的患病率).
- 大多数新的CKD病例是KDIGO中度风险 (75%),其中1.1%需要科转诊.
- 90%的患者开始/优化了指导方针导向治疗,平均试剂成本为0.51欧元/被查的人.
结论:
- 在初级保健中,CDSS支持的机会性CKD查是可行的,可以接受的,并且具有成本效益.
- 这种方法成功地识别了以前未被识别的CKD,使早期管理能够潜在地减缓进展.
- 建议对长期结果进行进一步的评估,以扩大这种查策略.
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