Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
Am J Manag Care. 2009 Nov;15(11):809-14.
To test the efficacy of an electronic asthma monitoring system (AMS) to reduce pediatric emergency department (ED) visits and hospitalizations for asthma.
Randomized clinical trial.
Families of pediatric patients with asthma aged 8 to 17 years were recruited at 6 medical centers. Children were randomly assigned to the American Medical Alert Corporation pediatric AMS or a paper diary. The numbers of and costs associated with ED visits and hospitalizations for the 2 groups in the year following randomization were compared using t tests of statistical significance.
Of 59 children recruited to the trial, 29 were randomized to the AMS and 30 to the diary. The 2 groups were similar in demographic and clinical characteristics. During their study year, 24 AMS group members logged on a mean (SD) of 211.0 (117.3) days; 13 diary group members provided data on a mean (SD) of 136.6 (128.0) days. During the 32 months that the study was in progress, the case managers logged on a mean (SD) of 171.0 (97.2) days. Overall, 35 children had at least 1 ED visit, but only 7 children were hospitalized. The 2 groups had no statistically significant differences in the numbers of or charges associated with ED visits or hospitalizations.
Electronic devices are being developed to make chronic disease management easier for patients and their families, but they should not be adopted without careful study, including randomized trials, to ascertain their use, costs, and benefits.
测试电子哮喘监测系统(AMS)减少儿科急诊就诊和哮喘住院的疗效。
随机临床试验。
在 6 家医疗中心招募年龄在 8 至 17 岁的哮喘患儿的家庭。将儿童随机分配到美国医疗警报公司的儿科 AMS 或纸质日记组。使用统计学显著 t 检验比较两组在随机分组后一年内的急诊就诊次数和费用。
59 名参加试验的儿童中,29 名被随机分配到 AMS 组,30 名被分配到日记组。两组在人口统计学和临床特征方面相似。在他们的研究年度中,24 名 AMS 组成员平均(SD)登录 211.0(117.3)天;13 名日记组成员平均(SD)记录了 136.6(128.0)天。在研究进行的 32 个月中,病例管理者平均(SD)登录 171.0(97.2)天。总体而言,35 名儿童至少有 1 次急诊就诊,但只有 7 名儿童住院。两组在急诊就诊次数或相关费用方面无统计学差异。
电子设备的开发旨在使患者及其家属的慢性病管理更加容易,但在采用这些设备之前,应该进行仔细的研究,包括随机试验,以确定其使用、成本和效益。