Evaluation of health alerts from an early illness warning system in independent living.
Evaluation of health alerts from an early illness warning system in independent living.
复制标题
对独立生活早期疾病预警系统健康警报的评估。
DOI：
10.1097/nxn.0b013e318296298f
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Back,Jessica
中科院分区：
文献类型：
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作者：
Rantz,MarilynJ;Scott,SusanD;Miller,StevenJ;Skubic,Marjorie;Phillips,Lorraine;Alexander,Greg;Koopman,RichelleJ;Musterman,Katy;Back,Jessica
被动传感器网络部署在独立的生活公寓中，以监测家庭环境中的老年人，以检测即将发生疾病的迹象，并提醒临床医生，以便他们能够干预并预防或延迟健康或功能状态的重大变化。进行了回顾性定性演绎内容分析，以完善健康警报，以提高临床医生的临床相关性，因为他们在日常护理提供给老年人的正常工作流程中使用警报。临床医生填写了书面自由文本框，以描述由于每个警报而采取（或不采取）的措施;他们还在1至5的量表上对每个健康警报的临床意义（相关性）进行了评级。两个样本的临床医生的书面答复的健康警报进行了分析后，警报算法已调整的基础上，使用健康警报，以提高临床决策的试点研究的结果。在第一个样本中，7名临床医生针对385个唯一警报生成了总计663条评论;评论多于警报，因为不止一名临床医生对同一警报进行了评级。第二个样本共有142条评论，由三名临床医生对88个不同的警报做出回应。根据临床医生对每个警报的定性评论内容判断，警报的总体临床相关性从第一个样本中被分类为临床相关的警报的33.3%提高到第二个样本中的43.2%。其目标是产生临床相关的警报，临床医生发现在日常实践中有用。所使用的评估方法被描述为帮助其他人，因为他们考虑建立和反复完善健康警报，以提高临床决策。
Passive sensor networks were deployed in independent living apartments to monitor older adults in their home environments to detect signs of impending illness and alert clinicians so they can intervene and prevent or delay significant changes in health or functional status. A retrospective qualitative deductive content analysis was undertaken to refine health alerts to improve clinical relevance to clinicians as they use alerts in their normal workflow of routine care delivery to older adults. Clinicians completed written free-text boxes to describe actions taken (or not) as a result of each alert; they also rated the clinical significance (relevance) of each health alert on a scale of 1 to 5. Two samples of the clinician’s written responses to the health alerts were analyzed after alert algorithms had been adjusted based on results of a pilot study using health alerts to enhance clinical decision-making. In the first sample, a total of 663 comments were generated by seven clinicians in response to 385 unique alerts; there are more comments than alerts because more than one clinician rated the same alert. The second sample had a total of 142 comments produced by three clinicians in response to 88 distinct alerts. The overall clinical relevance of the alerts, as judged by the content of the qualitative comments by clinicians for each alert, improved from 33.3% of the alerts in the first sample classified as clinically relevant to 43.2% in the second. The goal is to produce clinically relevant alerts that clinicians find useful in daily practice. The evaluation methods used are described to assist others as they consider building and iteratively refining health alerts to enhance clinical decision making.