Aagaard Eva M, Nadler Paul, Adler Joshua, Maselli Judith, Gonzales Ralph
Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA, USA.
J Gen Intern Med. 2006 Nov;21(11):1156-9. doi: 10.1111/j.1525-1497.2006.00575.x. Epub 2006 Jul 19.
To validate and implement a computer module for the management of uncomplicated urinary tract infections (UTI).
Women age 18 to 64 years, with a previous UTI, voiding symptoms, and absence of complicating features (comorbidities, vaginal discharge, back pain, emesis, and fever/chills).
The computer module was validated against clinician diagnosis and urine culture. Following validation, the module was implemented in the urgent care clinic as a management option for women with suspected UTI; computer-directed therapy (CDT)-eligible women received antibiotic treatment without a clinician examination. Patient satisfaction with the module and return visits for UTI-related complaints were assessed.
In the validation study, 18 of 68 women (26%) were CDT-eligible. Clinicians diagnosed 17/18 CDT-eligible women with uncomplicated UTI. Sixty-seven percent of CDT-eligible women had a positive urine culture. Since implementation, 162 women have accessed the module, and 35% have received CDT. Ninety-eight percent (95% confidence interval: 95% to 100%) found the program easy to use and 95% (89% to 100%) would recommend it to friends/family. Two (4%) CDT-treated women had a return visit to our institution for a UTI-related illness within 2 weeks.
A computer module accurately identifies women with culture-confirmed, uncomplicated UTIs. Patients are highly satisfied with the module.
验证并实施一个用于管理单纯性尿路感染（UTI）的计算机模块。
年龄在18至64岁之间、既往有UTI病史、有排尿症状且无复杂特征（合并症、阴道分泌物、背痛、呕吐及发热/寒战）的女性。
该计算机模块经与临床医生诊断及尿培养结果对比进行验证。验证后，该模块在紧急护理诊所作为疑似UTI女性的一种管理选项实施；符合计算机指导治疗（CDT）条件的女性无需临床医生检查即可接受抗生素治疗。评估了患者对该模块的满意度以及因UTI相关投诉的复诊情况。
在验证研究中，68名女性中有18名（26%）符合CDT条件。临床医生诊断18名符合CDT条件的女性中有17名患有单纯性UTI。67%符合CDT条件的女性尿培养呈阳性。自实施以来，有162名女性使用了该模块，其中35%接受了CDT。98%（95%置信区间：95%至100%）的人认为该程序易于使用，95%（89%至100%）的人会向朋友/家人推荐。两名（4%）接受CDT治疗的女性在2周内因UTI相关疾病返回我院复诊。
一个计算机模块能准确识别经培养确诊的单纯性UTI女性。患者对该模块高度满意。
