High levels of healthcare utilization prior to diagnosis in idiopathic pulmonary arterial hypertension support the feasibility of an early diagnosis algorithm: the SPHInX project.
High levels of healthcare utilization prior to diagnosis in idiopathic pulmonary arterial hypertension support the feasibility of an early diagnosis algorithm: the SPHInX project.
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DOI：
10.1177/2045894018798613
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发表时间：
2018-10
影响因子：
2.6
通讯作者：
SPHInX Project team
中科院分区：
文献类型：
--
作者：
Bergemann R;Allsopp J;Jenner H;Daniels FA;Drage E;Samyshkin Y;Schmitt C;Wood S;Kiely DG;Lawrie A;SPHInX Project team
特发性肺动脉高压 (iPAH) 是一种罕见的进行性、缩短寿命的疾病，通常在晚期诊断。我们假设 iPAH 患者在诊断前表现出寻求健康的行为模式，这将有助于开发早期识别工具。谢菲尔德肺动脉高压指数 (SPHInX) 项目旨在开发一种基于常规收集的医疗资源利用 (HCRU) 数据的预测算法。本报告重点关注该项目的初步可行性，研究来自英国国家卫生服务中心的医院发作统计（HES）数据是否足够丰富以支持早期诊断算法的开发。这是一个两阶段的研究。首先，HES 数据中捕获的 2009 年至 2014 年期间医院互动确定了 127,815 名患有肺动脉高压 (PH) ICD-10 代码的成年患者，其中包含一个可能的 iPAH 队列，其发病率和人口统计数据与文献报道相似。诊断前三年 HCRU 较高。其次，为了检查确诊 iPAH 患者的 HCRU，我们构建了 SPHInX 数据集，其中纳入了 2008 年至 2016 年谢菲尔德肺血管疾病科调查的所有疑似 PH 患者 (n = 6674)。对于 SPHInX 数据集，98.6% 的病例数据可以与 HES 关联，并且确诊 iPAH 的患者具有相似的诊断前 HCRU 水平。总之，使用 HES 识别的疑似 iPAH 患者和确诊 iPAH 患者在诊断前数年都具有高水平 HCRU。人工智能模型现在将用于开发 SPHInX 算法，以筛查普通人群中未确诊的 iPAH。
Idiopathic pulmonary arterial hypertension (iPAH) is a rare progressive, life-shortening disease, usually diagnosed at an advanced stage. We hypothesize that patients with iPAH exhibit patterns of health-seeking behavior before diagnosis that will allow the development of earlier identification tools. The Sheffield Pulmonary Hypertension IndeX (SPHInX) project aims to develop a predictive algorithm based on routinely collected healthcare resource utilization (HCRU) data. This report focuses on the initial feasibility of the project, examining whether Hospital Episode Statistics (HES) data from the National Health Service in England have sufficient richness to support the development of an early diagnosis algorithm. This is a two-stage study. First, hospital interactions during 2009–2014 captured in HES data identified 127,815 adult patients with pulmonary hypertension (PH) ICD-10 codes, containing a probable iPAH cohort with incidence and demographics similar to the reported literature. HCRU was high in the three years before diagnosis. Second, to examine HCRU in patients with a confirmed iPAH diagnosis, we built the SPHInX dataset incorporating all patients investigated for suspected PH in the Sheffield Pulmonary Vascular Disease Unit during 2008–2016 (n = 6674). For the SPHInX dataset, data could be linked to HES in 98.6% of cases and patients with confirmed iPAH had similar levels of pre-diagnosis HCRU. In conclusion, patients with probable iPAH identified using HES and patients with confirmed iPAH have high levels of HCRU for several years before diagnosis. Artificial intelligence models will now be used to develop the SPHInX algorithm to screen for undiagnosed iPAH in the general population.
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影响因子：
24
作者：
Humbert, M;Morrell, NW;Rabinovitch, M
通讯作者：
Rabinovitch, M
影响因子：
9.6
作者：
Badesch, David B.;Raskob, Gary E.;McGoon, Michael D.
通讯作者：
McGoon, Michael D.
影响因子：
168.9
作者：
Galie, N.;Rubin, L. J.;Simonneau, G.
通讯作者：
Simonneau, G.
影响因子：
24.3
作者：
Peacock, A. J.;Murphy, N. F.;Stewart, S.
通讯作者：
Stewart, S.
DOI：
10.1164/rccm.201203-0383oc
发表时间：
2012-10-15
影响因子：
24.7
作者：
Ling, Yi;Johnson, Martin K.;Peacock, Andrew J.
通讯作者：
Peacock, Andrew J.