■提高哮喘加重的准确风险评估,并且通过改变哮喘患者的相关行为来减少哮喘患者可以挽救生命并降低医疗保健成本。我们使用常规医疗保健数据中收集的因素开发了一个简单的个性化哮喘恶化风险预测模型,用于自动对话系统的风险建模功能。
■我们使用了来自英国临床实践研究数据链(CPRD)Aurum数据库的假名初级保健电子医疗记录。我们使用逻辑回归组合预测哮喘加重的变量,包括年龄,性别,种族,多重剥夺指数,与哮喘事件相关的地理区域和临床变量。
■我们将1,203,741名患者分为三个队列以实施时间验证:训练样本中的898,763名(74.7%),测试样本226,754(18.8%),验证样本78,224(6.5%)。完整模型的ROC曲线下面积(AUC)为0.72,受限模型为0.71。使用0.1的分界点,与所有患者都被视为高风险的策略相比,每100名患者的临床医生进行的大约27项哮喘评论将被预防。与没有恶化的患者相比,恶化的患者年龄较大,更有可能是女性,在过去的12个月里开了更多的SABA和ICS,有GORD的历史,COPD,焦虑,抑郁症,生活在非常贫困的地区,患有更严重的疾病。
■使用常规收集的电子医疗记录数据提供的信息,我们开发了一个模型,该模型具有中等能力,能够将自指数日期起3个月内出现哮喘加重的患者与未出现哮喘加重的患者分开.将此模型与简化模型进行比较时,该模型具有可以通过WhatsApp聊天机器人轻松自我报告的变量,我们已经表明,该模型的预测性能没有实质性差异。
UNASSIGNED: Improving accurate risk assessment of asthma exacerbations, and reduction via relevant behaviour change among people with asthma could save lives and reduce health care costs. We developed a simple personalised risk prediction model for asthma exacerbations using factors collected in routine healthcare data for use in a risk modelling feature for automated conversational systems.
UNASSIGNED: We used pseudonymised primary care electronic healthcare records from the Clinical Practice Research Datalink (CPRD) Aurum database in England. We combined variables for prediction of asthma exacerbations using logistic regression including age, gender, ethnicity, Index of Multiple Deprivation, geographical region and clinical variables related to asthma events.
UNASSIGNED: We included 1,203,741 patients divided into three cohorts to implement temporal validation: 898,763 (74.7%) in the training sample, 226,754 (18.8%) in the testing sample and 78,224 (6.5%) in the validation sample. The Area under the ROC curve (AUC) for the full model was 0.72 and for the restricted model was 0.71. Using a cut-off point of 0.1, approximately 27 asthma reviews by clinicians per 100 patients would be prevented compared with a strategy that all patients are regarded as high risk. Compared with patients without an exacerbation, patients who exacerbated were older, more likely to be female, prescribed more SABA and ICS in the preceding 12 months, have history of GORD, COPD, anxiety, depression, live in very deprived areas and have more severe disease.
UNASSIGNED: Using information available from routinely collected electronic healthcare record data, we developed a model that has moderate ability to separate patients who had an asthma exacerbation within 3 months from their index date from patients who did not. When comparing this model with a simplified model with variables that can easily be self-reported through a WhatsApp chatbot, we have shown that the predictive performance of the model is not substantially different.