使用电子医疗记录的难以治疗的喘与皮质类固醇过度使用的计算表型
Nikki C C Werkman1, Angelique Egberts1, Youssra Bais1
1Department of Clinical Pharmacy, Franciscus, Rotterdam and Schiedam, The Netherlands.
The journal of allergy and clinical immunology. Global
|February 24, 2026
概括
一个新的查询识别了难以治疗的喘患者,尽管进行了密集治疗,但这种情况经常被忽视. 这种计算表型有助于优化对那些症状不受控制和过度使用口服皮质类固醇的人的护理.
科学领域:
- 肺部病理学 肺部病理学
- 医疗信息学 医疗信息学
- 临床流行病学临床流行病学
背景情况:
- 难以治疗的喘导致症状控制不良和口服皮质类固醇 (OCS) 的过度使用.
- 过度使用OCS导致患者和经济负担显著.
- 许多难以治疗的喘患者仍然未被诊断或治疗不足.
研究的目的:
- 开发一种计算表型 (查询) 用于识别难以治疗的喘患者.
- 为这些患者提供最佳的治疗策略.
- 改善需要高级喘管理的患者的识别.
主要方法:
- 利用两个荷兰医院 (弗朗西斯克斯和阿德米拉尔·德·鲁特医院) 的电子健康记录.
- 开发了一个结构化查询语言 (SQL) 查询,以基于高剂量吸入皮质类固醇和OCS使用来定义难以治疗的喘.
- 通过肺病学家和药剂师的手动记录审查验证了查询的性能.
主要成果:
- 包括来自弗朗西斯科斯的1217名患者和来自阿德兹的267名患者.
- 查询确定了使用高剂量吸入性皮质类固醇和OCSs (≥2个高剂量疗程或≥90天低剂量疗程) 的患者.
- 在弗朗西斯卡斯中获得了0.75的灵敏度和0.76的特异性;在阿德瑞斯中获得了0.40的灵敏度和0.95的特异性.
结论:
- 开发的查询有效地识别了难以治疗的喘患者.
- 这个工具有助于识别经历过度使用OCS的患者.
- 促进严重喘病例的及时干预和治疗优化.
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