Acute pulmonary embolism: cost-effectiveness analysis of the effect of artificial neural networks on patient care.
Acute pulmonary embolism: cost-effectiveness analysis of the effect of artificial neural networks on patient care.
复制标题
急性肺栓塞：人工神经网络对患者护理影响的成本效益分析。
DOI：
10.1148/radiology.206.1.9423655
复制
发表时间：
1998
期刊：
影响因子：
19.7
通讯作者：
Coleman,RE
中科院分区：
文献类型：
--
作者：
Tourassi,GD;Floyd,CE;Coleman,RE
评估人工神经网络诊断的成本效益在怀疑有急性肺栓塞的患者通常是指肺angiography.MATERIALS和METHODS四个诊断策略进行了探讨，以帮助确定神经网络的诊断作用，在怀疑有肺栓塞的患者中，非诊断性通气灌注肺扫描获得。首先，使用网络来确定哪些患者可以直接转诊进行治疗而无需血管造影。其次，该网络被用于确定哪些患者可以停止治疗。第三，该网络用于区分网络给出不确定响应的患者和应该进行血管造影的患者。每种策略都与使用血管造影术的发病率，死亡率和挽救生命的成本进行了比较。神经网络的使用使每位患者的平均成本相对于血管造影术的成本降低了一半以上。发病率和死亡率也与血管造影术相关者相当或更低。结果是一致的，无论疾病的患病率。CONCLUSIONThe使用神经网络在肺栓塞的诊断是一个很有前途的方法，以提高成本效益的护理患者的非诊断肺扫描。
PURPOSETo evaluate the cost-effectiveness of artificial neural networks for diagnosis in patients suspected of having acute pulmonary embolism who are typically referred for pulmonary angiography.MATERIALS AND METHODSFour diagnostic strategies were explored to help define the diagnostic role of neural networks in patients suspected of having pulmonary embolism in whom nondiagnostic ventilation-perfusion lung scans were obtained. First, a network was used to determine which patients could be directly referred for treatment without angiography. Second, the network was applied to determine in which patients treatment could be withheld. Third, the network was used to distinguish patients in whom the network gave indeterminate responses and who should proceed to angiography. Each strategy was compared with use of angiography in terms of morbidity, mortality, and cost per life saved.RESULTSThe use of the neural network reduced the average cost per patient by more than one-half relative to the cost of angiography. Morbidity and mortality rates were also comparable to or lower than those associated with angiography. The results were consistent regardless of the prevalence of disease.CONCLUSIONThe use of neural networks in the diagnosis of pulmonary embolism is a promising way to improve cost-effectiveness in the care of patients with nondiagnostic lung scans.