External Validity of Electronic Sniffers for Automated Recognition of Acute Respiratory Distress Syndrome.
External Validity of Electronic Sniffers for Automated Recognition of Acute Respiratory Distress Syndrome.
复制标题
DOI：
10.1177/0885066617720159
复制
发表时间：
2019-11
影响因子：
3.1
通讯作者：
Wanderer JP
中科院分区：
文献类型：
--
作者：
McKown AC;Brown RM;Ware LB;Wanderer JP
自动电子嗅探器可能有助于早期发现急性呼吸窘迫综合征 (ARDS)，以便进行治疗或临床试验筛查。在 2929 名重症患者的前瞻性队列中，我们回顾性应用已发表的嗅探算法来自动检测急性肺损伤，以评估其在 ICU 前 4 天诊断 ARDS 的效用。检索放射照相全文报告中的“水肿”或（“双侧”和“浸润”）以及与 ARDS 一致的描述的更详细算法。如果 X 光片符合搜索标准并且 PaO2/FiO2 或 SpO2/FiO2 分别为 300 或 315，则患者被标记为可能的 ARDS。将电子嗅探器的测试特征和 ARDS 的临床怀疑与 2 名医生判定的 ARDS 的黄金标准进行比较。分析中纳入的 2841 名患者中有 30% 具有 ARDS 的金标准诊断。在 4 天的研究期间，更简单的算法对 ARDS 的敏感性为 78.9%，特异性为 52%，阳性预测值 (PPV) 为 41%，阴性预测值 (NPV) 为 85.3%。更详细的算法的敏感性为 88.2%，特异性为 55.4%，PPV 为 45.6%，NPV 为 91.7%。两种算法都比临床医生怀疑更敏感，但特异性较差，其敏感性为 40.7%，特异性为 94.8%，PPV 为 78.2%，NPV 为 77.7%。已发布的 ARDS 电子嗅探器算法可能是 ARDS 的有用自动筛查工具，并改善临床识别，但它们仅限于筛查而不是诊断，因为其特异性较差。
Automated electronic sniffers may be useful for early detection of acute respiratory distress syndrome (ARDS) for institution of treatment or clinical trial screening. In a prospective cohort of 2929 critically ill patients, we retrospectively applied published sniffer algorithms for automated detection of acute lung injury to assess their utility in diagnosis of ARDS in the first 4 ICU days. Radiographic full-text reports were searched for “edema” OR (“bilateral” AND “infiltrate”) and a more detailed algorithm for descriptions consistent with ARDS. Patients were flagged as possible ARDS if a radiograph met search criteria and had a PaO2/FiO2 or SpO2/FiO2 of 300 or 315, respectively. Test characteristics of the electronic sniffers and clinical suspicion of ARDS were compared to a gold standard of 2-physician adjudicated ARDS. Thirty percent of 2841 patients included in the analysis had gold standard diagnosis of ARDS. The simpler algorithm had sensitivity for ARDS of 78.9%, specificity of 52%, positive predictive value (PPV) of 41%, and negative predictive value (NPV) of 85.3% over the 4-day study period. The more detailed algorithm had sensitivity of 88.2%, specificity of 55.4%, PPV of 45.6%, and NPV of 91.7%. Both algorithms were more sensitive but less specific than clinician suspicion, which had sensitivity of 40.7%, specificity of 94.8%, PPV of 78.2%, and NPV of 77.7%. Published electronic sniffer algorithms for ARDS may be useful automated screening tools for ARDS and improve on clinical recognition, but they are limited to screening rather than diagnosis because their specificity is poor.
登录
查看更多内容
影响因子：
8.8
作者：
Koenig, Helen C.;Finkel, Barbara B.;Fuchs, Barry D.
通讯作者：
Fuchs, Barry D.
影响因子：
9.6
作者：
Schmickl, Christopher N.;Shahjehan, Khurram;Gajic, Ognjen
通讯作者：
Gajic, Ognjen
影响因子：
158.5
作者：
Papazian, Laurent;Forel, Jean-Marie;Roch, Antoine
通讯作者：
Roch, Antoine
DOI：
10.1109/bibmw.2009.5332081
发表时间：
2009-11
期刊：
Proceedings. IEEE International Conference on Bioinformatics and Biomedicine
影响因子：
--
作者：
Solti I;Cooke CR;Xia F;Wurfel MM
通讯作者：
Wurfel MM
影响因子：
9.6
作者：
Rice, Todd W.;Wheeler, Arthur P.;Ware, Lorraine B.
通讯作者：
Ware, Lorraine B.