Orbital fracture clinical decision rule development: burden of disease and use of a mandatory electronic survey instrument.
Orbital fracture clinical decision rule development: burden of disease and use of a mandatory electronic survey instrument.
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眼眶骨折临床决策规则的制定：疾病负担和强制性电子调查仪器的使用。
DOI：
10.1111/j.1553-2712.2011.01017.x
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Gennis,Paul
中科院分区：
文献类型：
--
作者：
Yadav,Kabir;Cowan,Ethan;Wall,Stephen;Gennis,Paul
学术急诊医学2011；摘要目的：为了制定临床决策规则（CDR）以提高计算机断层扫描（CT）诊断眶骨折的效率，作者试图估计急诊部（EDs）每年眶骨折的发病率以及CT诊断的使用情况。作者还试图评估一种强制性电子数据收集工具（EDCI），该工具由供应商管理，以促进CDR数据收集。方法：通过分析2007年全国医院门诊医疗调查（NHAMCS）数据库进行全国估计，采用医院计费系统和编码数据进行地方估计。EDCI集成到CT订购系统中，因此供应商必须完成表格才能执行CT。由于每次订购CT都必须填写EDCI，因此数据收集效率是通过依从性（计算不切实际的数据收集工具答案的数量）和完成EDCI的供应商的方便样本来衡量的。结果：2007年，在美国的1.168亿急诊科就诊中，有410万患者因眼睛和面部受伤而接受治疗。其中，820252名患者接受了CT成像，102999名患者（12.5%）被诊断为眼眶骨折。在我们当地的医院系统中，每年有122,500例急诊就诊，752例眶部ct检查，其中172例（23%）眶部骨折。EDCI符合率为94.9%，完成时间不到5分钟。结论：国家和地方的数据表明，CT成像在识别眶骨折方面的成功率很低。使用与计算机化医生订单输入相连接的强制性EDCI收集数据可以提供前瞻性、连续的患者数据，这些数据用于开发CDR，以便在眼眶外伤中选择性地使用CT成像。该决策规则可提高眼眶骨折的诊断效率，从而改善患者护理，减少辐射暴露，降低成本。学术急诊医学2011；18:1-4©2011由学术急诊医学学会主办
ACADEMIC EMERGENCY MEDICINE 2011; 18:313–316 © 2011 by the Society for Academic Emergency MedicineAbstractObjectives:In preparation for development of a clinical decision rule (CDR) to promote more efficient use of computed tomography (CT) for diagnosing orbital fractures, the authors sought to estimate the annual incidence of orbital fractures in emergency departments (EDs) and the usage of CT to make these diagnoses. The authors also sought to evaluate a mandatory electronic data collection instrument (EDCI) administered to providers to facilitate CDR data collection.Methods:National estimates were made by analyzing the 2007 National Hospital Ambulatory Medical Care Survey (NHAMCS) database, while hospital billing system and coding data were used to make local estimates. An EDCI was integrated into the CT ordering system such that providers had to complete the form to perform a CT. Because the EDCI had to be filled out for every CT ordered, data collection efficiency was measured by compliance (counting the number of unrealistic data collection instrument answers) and by timing a convenience sample of providers completing the EDCI.Results:Out of 116.8 million ED visits in the United States in 2007, 4.1 million patients were treated for injuries of the eye and face. Of those, 820,252 patients underwent CT imaging, with 102,999 patients (12.5%) diagnosed with an orbital fracture. In our local hospital system with 122,500 annual ED visits, 752 CTs of orbits were performed, with 172 (23%) orbital fractures. The EDCI compliance rate was 94.9% and took less than 5 minutes to complete.Conclusions:National and local data demonstrate a low yield for CT imaging in identifying orbital fractures. Data collection using a mandatory EDCI linked to computerized provider order entry can provide prospective, consecutive patient data that are needed to develop a CDR for the selective use of CT imaging in orbital trauma. Such a decision rule could increase the efficiency in diagnosing orbital fractures, thereby improving patient care, reducing radiation exposure, and decreasing costs.ACADEMIC EMERGENCY MEDICINE 2011; 18:1–4 © 2011 by the Society for Academic Emergency Medicine
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评估转录临床数据的准确性。
DOI：
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发表时间：
1993
期刊：
Proceedings. Symposium on Computer Applications in Medical Care
影响因子：
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作者：
Richard Wilton;A. Pennisi
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影响因子：
3.8
作者：
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发表时间：
1987
期刊：
Advances in ophthalmic plastic and reconstructive surgery
影响因子：
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CT：注意辐射剂量
DOI：
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发表时间：
2000
期刊：
影响因子：
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作者：
Madan M. Rehani
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DOI：
--
发表时间：
2001
期刊：
AJNR. American journal of neuroradiology
影响因子：
--
作者：
Kenneth D. Hopper;Joel D. Neuman;Steven H. King;Allen R. Kunselman
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Allen R. Kunselman