Data, data everywhere.
Data, data everywhere.
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DOI：
10.1097/00003246-199708000-00004
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发表时间：
1997-08
影响因子：
8.8
通讯作者：
L. Nelson
中科院分区：
文献类型：
--
作者：
L. Nelson
毫无疑问，在重症监护室（ICU）中，我们被大量的数据淹没了。毫无疑问，大部分数据的质量都有问题。在这一期的《重症监护医学》中，Weissman博士[1]已经证明，在一个典型的ICU中，许多医院捕获的基本诊断信息只能很好地反映导致ICU入院的诊断。在不到60%的病例中，出院诊断直接或间接反映了ICU入院诊断。值得注意的是，在36%的病例中，出院诊断甚至没有反映导致ICU入院的主要器官系统。作者得出结论，虽然出院时编码的管理数据可用于计费目的，但它们对ICU质量管理和其他功能没有用处。作者建议重症监护医师和ICU主任建立他们自己的数据库，以获得有关ICU资源利用的有意义的信息。我们经常在真空中练习，认为我们的治疗是最佳的。我们使用我们被教导或通过经验获得的实践。我们通过从医学文献或”专家”提供的继续医学教育项目中学到的原则来调整我们的实践，这些专家通常与我们自己处于相同的”数据空白”中。影响我们实践的学习原则很少能直接应用于特定ICU中的单个患者或患者组。我们的实践很少是”以证据为基础的“。"
There is no doubt in the mind of any intensivist that we are overwhelmed with a sea of data in the intensive care unit (ICU). There is also little question that much of the data is of questionable quality. In this issue of Critical Care Medicine, Dr. Weissman [1] has demonstrated that in an exemplary ICU, fundamental diagnostic information captured by many hospitals only very poorly reflects the diagnoses resulting in ICU admission. In less than 60% of cases did the hospital discharge diagnosis directly or indirectly reflect the ICU admission diagnosis. Remarkably, in 36% of cases, the hospital discharge diagnosis did not even reflect the primary organ system resulting in ICU admission. The authors conclude that while administrative data coded at the time of hospital discharge are useful for billing purposes, they are not useful for ICU quality management and other functions. The author recommends that intensivists and ICU directors establish their own databases to obtain meaningful information regarding ICU resource utilization.What information do intensivists need? We frequently practice in a vacuum, thinking our treatment is optimal. We use practices that we were taught or have acquired by experience. We tune our practices through principles learned from the medical literature or continuing medical education programs presented by" experts," who are often in the same" data void" as we ourselves. Learned principles affecting our practices rarely can be applied directly to individual patients or groups of patients in a particular ICU. Seldom are our practices" evidenced-based."