Assessment of guideline for laboratory use using the method of decision science

使用决策科学方法评估实验室使用指南

• 批准号: 04671436
• 负责人: INOUE Yuji
• 金额: $ 1.28万
• 依托单位: Yamaguchi University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1992
• 资助国家: 日本
• 起止时间: 1992 至 1993
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-04671436/
• 关键词: Laboratory diagnostics; Decision science; Urinary Tract Infection; Urinalysis; Bacteriological exam; データベース; 検査診断学; 尿一般検査; グラム染色検査

The guideline for appropriate laboratory use in the care of Urinary Tract Infections(UTI) was made by using the methods of decision science.Laboratory data of microbiological examination in Laboratory information system and health record date in hospital information system were connected and reconstructed to the relational data-base to assess the clinical epidemiologic findings. Dysuria was a good indicator to predict UTI from the symptoms and signs related to urinary tract disorders, and ROC analysis of qualitative urinalysis and urinary sediments were done. The sensitivity and specificity of the gram stain testing for identifying gram negative and gram positive pathogens were also determined.Using a decision analysis model, the strategy of the initial therapy of antibiotics without testing was compared with that of the initial testing and selectiong the antibiotics according to the test results. A 90% of pretest probability of pathogens to be gram negative rods was the critical point to decide to do or not to do urine gram stain for selection of antibiotics.During the course of this study, we processed the multicenter patient database and recognized the importance to standardize the codes and items in the information systems.

运用决策科学的方法，制定实验室在尿路感染护理中的合理使用指南，将实验室信息系统中的微生物检验数据和医院信息系统中的健康记录数据连接并重建到关系数据库中，以评估临床流行病学结果。根据与尿路疾病相关的症状和体征，排尿困难是预测尿路感染的良好指标，并进行了定性尿液分析和尿沉渣ROC分析。同时测定革兰氏染色试验对革兰氏阴性和革兰氏阳性病原菌鉴定的敏感性和特异性，并利用决策分析模型对不经检测的抗生素初始治疗策略与初始检测策略进行比较，根据检测结果选择抗生素。在本研究过程中，我们对多中心患者数据库进行了处理，认识到信息系统中编码和项目标准化的重要性。

项目成果

Yuji INOUE, Sachiko HORITA: "Laboratory evaluation of the urine gram stain for a guide to initial antibiotic therapy of urinary tract infections" 12nd Proceeding for Medical Informatics. 543-546 (1992)

Yuji INOUE、Sachiko HORITA：“尿液革兰氏染色的实验室评估作为尿路感染初始抗生素治疗的指南”第 12 期医学信息学论文集。

Yuji INOUE: "Standardization clinical Laboratory information" Computer and Medicine. 5(5). 428-433 (1993)

Yuji INOUE：“标准化临床实验室信息”计算机和医学。

井上裕二: "医学判断学の基本的技法の実際.判断分析" 臨床病理. 特集93. 83-93 (1993)

Yuji Inoue：“医学判断基本技术的实践。判断分析”临床病理学专题 93. 83-93 (1993)

Yuji INOUE, Tsugaya FUKUI, Masashi SHIRAHAMA: "Information value of clinical signs and stat tests as indicators of female outpatient urinary tract infection" Jap J Clin Pathol. 40(1). 42-48 (1992)

Yuji INOUE、Tsugaya FUKUI、Masashi SHIRAHAMA：“临床症状和统计测试作为女性门诊尿路感染指标的信息价值”Jap J Clin Pathol。

井上裕二: "臨床検査情報の標準化" 医療とコンピュータ. 5. 428-433 (1993)

Yuji Inoue：“临床试验信息的标准化”医学和计算机。5. 428-433 (1993)。