Bauke A de Boer, Tatum T van Laar, Firmin Candido, Karlijn J van Stralen, Anne Margreet de Jong
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引用次数: 0
摘要
背景 用于分析全科医生（GPs）患者贫血情况的荷兰指南算法已编入临床决策支持系统（CDS-anaemia），以支持实验室诊断贫血原因的过程。本研究旨在评估自动算法在不同人口统计类别（包括不同性别、年龄组和贫血严重程度）中提供的辅助效益，并与全科医生采用的人工诊断方法进行比较。方法 这是一项回顾性队列研究，研究对象是 5399 名初级保健患者，这些患者的贫血原因是由全科医生在使用或未使用 CDS-anaemia 的情况下诊断出来的，年龄段分别为 18-44、45-64、65-79 和 80 岁及以上。贫血的定义依据荷兰全科医师学院（Dutch College of General Practitioners，DCGP）指南。贫血的原因以荷兰全科医师学院指南为基础，并进行相应的血液检测。通过计算确定的贫血原因的比率和百分比差异，我们评估了诊断算法的效果。结果和结论 与未使用 CDS-anaemia 系统的全科医生相比，使用 CDS-anaemia 系统的全科医生在发现潜在贫血原因的患者中，男性和女性的比例分别增加了 34 和 46 个百分点。中青年男性和轻度或中度贫血患者使用 CDS-anaemia 的百分比增幅最大。
Automated tools for identifying the causes of anaemia in general practices are particularly advantageous for patients who do not fit the typical profile.
Background: The Dutch guideline algorithm for the analysis of anaemia in patients of general practitioners (GPs) was programmed in a Clinical Decision Support system (CDS-anaemia) to support the process of diagnosing the cause of anaemia in the laboratory. This research aims to assess the supplementary benefit provided by the automated algorithm in various demographic categories, including different sexes, age groups and severities of anaemia, in comparison to the manual diagnostic approach employed by GPs.
Methods: This was a retrospective cohort study of 5399 primary care patients where the cause of anaemia was diagnosed by GPs with or without the aid of CDS-anaemia within the age groups 18-44, 45-64, 65-79 and 80 and older. Anaemia was defined according to the Dutch College of General Practitioners (DCGP) guideline. Causes of anaemia were based on the DCGP guidelines with the corresponding blood tests. By calculation of rate ratios and percentage differences of the determined cause of anaemia we evaluated the effect of the diagnostic algorithm.
Results and conclusion: The percentage patients in which an underlying cause of anaemia was found increased 34 and 46 percentage points in females and males, respectively, when GPs were supported by CDS-anaemia compared to GPs who were not supported by CDS-anaemia. The highest increase in percentage points when CDS-anaemia was used, was found in younger- and middle-aged males and mild or moderate anaemia.
期刊介绍：
Annals of Clinical Biochemistry is the fully peer reviewed international journal of the Association for Clinical Biochemistry and Laboratory Medicine.
Annals of Clinical Biochemistry accepts papers that contribute to knowledge in all fields of laboratory medicine, especially those pertaining to the understanding, diagnosis and treatment of human disease. It publishes papers on clinical biochemistry, clinical audit, metabolic medicine, immunology, genetics, biotechnology, haematology, microbiology, computing and management where they have both biochemical and clinical relevance. Papers describing evaluation or implementation of commercial reagent kits or the performance of new analysers require substantial original information. Unless of exceptional interest and novelty, studies dealing with the redox status in various diseases are not generally considered within the journal''s scope. Studies documenting the association of single nucleotide polymorphisms (SNPs) with particular phenotypes will not normally be considered, given the greater strength of genome wide association studies (GWAS). Research undertaken in non-human animals will not be considered for publication in the Annals.
Annals of Clinical Biochemistry is also the official journal of NVKC (de Nederlandse Vereniging voor Klinische Chemie) and JSCC (Japan Society of Clinical Chemistry).
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