Computerised clinical decision support for suspected PE

被引:18
|
作者
Jimenez, David [1 ,2 ]
Resano, Santiago [3 ,4 ]
Otero, Remedios [5 ]
Jurkojc, Carolina [1 ,2 ]
Portillo, Ana Karina [4 ,6 ]
Ruiz-Artacho, Pedro [7 ]
Corres, Jesus [4 ,8 ]
Vicente, Agustina [3 ,4 ]
den Exter, Paul L. [9 ]
Huisman, Menno V. [9 ]
Moores, Lisa [10 ]
Yusen, Roger D. [11 ,12 ]
机构
[1] IRYCIS, Hosp Ramon y Cajal, Resp Dept, Madrid 28034, Spain
[2] Univ Alcala de Henares, Madrid, Spain
[3] Hosp Ramon & Cajal, Dept Radiol, E-28034 Madrid, Spain
[4] IRYCIS, Madrid, Spain
[5] Hosp Univ Virgen Rocio, Resp Dept, Seville, Spain
[6] Hosp Ramon & Cajal, Dept Internal Med, E-28034 Madrid, Spain
[7] Hosp Clin Madrid, Emergency Dept, Madrid, Spain
[8] Hosp Ramon & Cajal, Emergency Dept, E-28034 Madrid, Spain
[9] Leiden Univ, Med Ctr, Dept Thrombosis & Hemostasis, Leiden, Netherlands
[10] Uniformed Serv Univ Hlth Sci, F Edward Hebert Sch Med, Bethesda, MD USA
[11] Washington Univ, Sch Med, Dept Pulm & Crit Care Med, St Louis, MO USA
[12] Washington Univ, Sch Med, Div Gen Med Sci, St Louis, MO USA
关键词
PULMONARY-EMBOLISM; MANAGEMENT;
D O I
10.1136/thoraxjnl-2014-206689
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
This study aimed to determine the effect of an evidence-based clinical decision support (CDS) algorithm on the use and yield of CT pulmonary angiography (CTPA) and on outcomes of patients evaluated in the emergency department (ED) for suspected PE. The study included 1363 consecutive patients evaluated for suspected PE in an ED during 12 months before and 12 months after initiation of CDS use. Introduction of CDS was associated with decreased CTPA use (55% vs 49%; absolute difference (AD), 6.3%; 95% CI 1.0% to 11.6%; p=0.02). The use of CDS was associated with fewer symptomatic venous thromboembolic events during follow-up in patients with an initial negative diagnostic evaluation for PE (0.7% vs 3.2%; AD 2.5%; 95% CI 0.9% to 4.6%; p<0.01).
引用
收藏
页码:909 / 911
页数:3
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