Use of computerized surveillance to detect nosocomial pneumonia in neonatal intensive care unit patients
Use of computerized surveillance to detect nosocomial pneumonia in neonatal intensive care unit patients
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DOI：
10.1016/j.ajic.2005.06.008
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发表时间：
2005-10-01
影响因子：
4.9
通讯作者：
Larson, E
中科院分区：
文献类型：
--
作者：
Haas, JP;Mendonça, EA;Larson, E
背景：肺炎监测困难且耗时。目的：比较新生儿重症监护病房（NICU）患者肺炎的传统感染控制专业人员（ICP）监测与使用基于自然语言处理器的自动检测系统对胸部X线报告进行计算机化监测的效果。方法：该系统评价了2年内2个NICU的胸部X线片。它根据来自国家医院感染监测系统定义的规则标记了指示肺炎的X射线，适用于放射学报告。从自动化系统的数据进行了比较，前瞻性收集的肺炎数据由ICP。结果：在新生儿重症监护室1的计算机化监测的敏感性为71%，特异性为99.8%。阳性预测值为7.9%，阴性预测值（NPV）> 99%。NICU 2的数据不完整。结论：计算机辅助监测有可能减少ICP工作量，使肺炎监测可行。高NPV意味着该系统可以安全地筛选出许多未感染患者的胸部X光片。然而，所有数据必须可用于计算机系统，并且必须以相同的方式进行分析，以获得可比的结果。
Background: Pneumonia surveillance is difficult and time-consuming. The definition is complicated, and there are many opportunities for subjectivity in determining infection status.Objective: To compare traditional infection control professional (ICP) surveillance for pneumonia among neonatal intensive care unit (NICU) patients with computerized surveillance of chest x-ray reports using an automated detection system based on a natural language processor.Methods: This system evaluated chest x-rays from 2 NICUs over a 2-year period. It flagged x-rays indicative of pneumonia according to rules derived from the National Nosocomial infection Surveillance System definition as applied to radiology reports. Data from the automated system were compared with pneumonia data collected prospectively by an ICP.Results: Sensitivity of the computerized surveillance in NICU 1 was 71%, and specificity was 99.8%. The positive predictive value was 7.9%, and the negative predictive value (NPV) was >99%. Data from NICU 2 were incomplete.Conclusions: Computer-assisted surveillance has the potential to decrease ICP workload and make pneumonia surveillance feasible. The high NPV means the system can safely screen out many chest x-rays of noninfected patients. However, all data must be available to the computer system and must be analyzed the same way for results to be comparable.