怀疑现象在紧急选分配差异中的好处
medRxiv : the preprint server for health sciences
|February 23, 2026
概括
种族差异存在于急诊室 (ED) 选中,特别是在风险较低的患者中. 一个自动化算法显示,非西班牙裔白人患者获得的分拣优先级高于同样情况的黑人和西班牙裔患者.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 临床信息学 临床信息学
- 健康 公平 卫生 公平
背景情况:
- 紧急诊所 (ED) 的分类对患者护理至关重要,但却表现出有记录的民族种族差异.
- 标准化选协议存在,但它们的应用在不同的人口群体之间有所不同.
研究的目的:
- 量化ED分拣任务中的种族差异.
- 开发和验证一个与紧急严重性指数 (ESI) 相仿的自动化算法,用于客观的分类评估.
- 调查算法决策支持对减少分拣差异的影响.
主要方法:
- 分析了美国四个地区 (成人和儿科) 的140万次ED遭遇.
- 开发基于ESI标准的自动分拣算法,以识别高急性症状和生命体征.
- 用因果推断,根据临床表现和医院背景进行调整,将护士分拣任务与算法得分进行比较.
主要成果:
- 在所有研究地点都观察到选任务中的显著种族差异.
- 差异在较低风险的患者中最为明显,白人患者比具有相似临床表现的黑人和西班牙裔患者获得更高的敏度指标.
- 在由护士和算法识别的高风险患者中,分辨差异是最小的或不存在的.
结论:
- 在ED诊断中种族差异很明显,特别是在不太严重的患者中.
- 一个基于ESI的自动分类算法可以帮助识别和潜在地减轻这些差异.
- 选中的算法决策支持可以减少差异,对患者流动的影响最小.
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