开发和实施人工智能强化护理模型,改善西班牙医院病房的患者安全。

IF 1.7 Q3 CRITICAL CARE MEDICINE Acute and Critical Care Pub Date : 2024-11-01 Epub Date: 2024-11-18 DOI:10.4266/acc.2024.00759
Alejandro Huete-Garcia, Sara Rodriguez-Lopez
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引用次数: 0

摘要

背景:及早发现住院病人的危急事件可改善临床疗效并降低死亡率。传统的预警评分系统,如国家预警评分 2 (NEWS2),能有效识别高危患者。整合人工智能(AI)可提高此类系统的预测准确性和运行效率。本研究介绍了一种人工智能增强型预警系统的开发和实施情况,该系统基于经修改的带有实验室参数的NEWS2量表(mNEWS2-Lab),并评估了其改善医院病房患者安全的能力:这项回顾性队列研究的对象是医院病房收治的 3,790 名成人,收集了实施 mNEWS2-Lab 方案前后的数据,包括人工智能增强型和非人工智能增强型。研究采用了多变量预测模型,并进行了统计分析,如费雪卡方检验、相对风险 (RR)、RR 降低以及各种人工智能模型(逻辑回归、决策树、神经网络)。此外,还分析了干预措施的经济成本:mNEWS2-Lab 量表,尤其是与人工智能模型结合使用时,是早期发现和预防住院患者危急事件的一种功能强大且经济有效的工具。
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Development and implementation of an artificial intelligence-enhanced care model to improve patient safety in hospital wards in Spain.

Background: Early detection of critical events in hospitalized patients improves clinical outcomes and reduces mortality rates. Traditional early warning score systems, such as the National Early Warning Score 2 (NEWS2), effectively identify at-risk patients. Integrating artificial intelligence (AI) could enhance the predictive accuracy and operational efficiency of such systems. The study describes the development and implementation of an AI-enhanced early warning system based on a modified NEWS2 scale with laboratory parameters (mNEWS2-Lab) and evaluates its ability to improve patient safety in hospital wards.

Methods: For this retrospective cohort study of 3,790 adults admitted to hospital wards, data were collected before and after implementing the mNEWS2-Lab protocol with and without AI enhancement. The study used a multivariate prediction model with statistical analyses such as Fisher's chi-square test, relative risk (RR), RR reduction, and various AI models (logistic regression, decision trees, neural networks). The economic cost of the intervention was also analyzed.

Results: The mNEWS2-Lab reduced critical events from 6.15% to 2.15% (RR, 0.35; P<0.001), representing a 65% risk reduction. AI integration further reduced events to 1.59% (RR, 0.26; P<0.001) indicating a 10% additional risk reduction and enhancing early warning accuracy by 15%. The intervention was cost-effective, resulting in substantial savings by reducing critical events in hospitalized patients.

Conclusions: The mNEWS2-Lab scale, particularly when integrated with AI models, is a powerful and cost-effective tool for the early detection and prevention of critical events in hospitalized patients.

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来源期刊
Acute and Critical Care
Acute and Critical Care CRITICAL CARE MEDICINE-
CiteScore
2.80
自引率
11.10%
发文量
87
审稿时长
12 weeks
期刊最新文献
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