The asthma prediction rule to decrease hospitalizations for children with asthma.
The asthma prediction rule to decrease hospitalizations for children with asthma.
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DOI：
10.1097/aci.0000000000000259
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发表时间：
2016-06
影响因子：
2.8
通讯作者：
Walsh CG
中科院分区：
文献类型：
--
作者：
Arnold DH;Sills MR;Walsh CG
本综述的目的是讨论哮喘急性发作儿童住院临床决策面临的挑战，以及哮喘预测规则（APR）的开发、内部验证和未来潜力，以提供有意义的临床决策支持，从而减少不必要的住院治疗。 APR 是使用急诊室治疗前可用的预测变量开发和内部验证的，并且在预测住院需求方面表现良好。室内空气中的氧饱和度和呼气相延长与住院需求的相关性最强。关于小儿哮喘预测规则的研究很少。我们使用床边可用的临床直观预测变量开发并内部验证了 APR。在纳入电子决策支持之前，APR 必须经过外部验证和影响分析，以确定使用该工具是否会改变临床医生的行为并改善患者的治疗结果。
The aim of the present review was to discuss the challenges around clinical decision-making for hospitalization of children with acute asthma exacerbations and the development, internal validation and future potential of the Asthma Prediction Rule (APR) to provide meaningful clinical decision-support that might decrease unnecessary hospitalizations. The APR was developed and internally validated using predictor variables available before treatment in the ED, and performed well to predict need-for-hospitalization. Oxygen saturation on room air and expiratory phase prolongation were most strongly associated with need-for-hospitalization. Research on prediction rules in pediatric asthma is rare. We developed and internally validated the APR using clinically intuitive predictor variables that are available at the bedside. Before incorporation in to electronic decision-support the APR must undergo external validation and an impact analysis to determine if use of this tool will change clinician behavior and improve patient outcomes.