Panzarasa Silvia, Quaglini Silvana, Sacchi Lucia, Cavallini Anna, Micieli Giuseppe, Stefanelli Mario
CBIM, Pavia, Italy.
Stud Health Technol Inform. 2010;160(Pt 2):939-43.
Controlled randomized clinical trials and meta-analyses show that stroke patients benefit from access to specialized Stroke Units, in terms of mortality, disability and dependency. However, many issues relating to stroke diagnosis and therapy and to the organization of stroke care remain to be solved and little is known about what interventions make Stroke Units more effective. It is also agreed that compliance with clinical practice guidelines improves health outcomes for these patients, but little is known about the relative weight of the different guideline recommendations. Over the last decade, many hospital- or population-based stroke registers have been set up with the aim of identifying specific key indicators able to monitor the quality and adequacy of acute stroke care. Registers seem to be adequate tools for collecting the data needed to analyze care processes, providing data useful for both national healthcare planning and scientific research. In this paper we applied data mining techniques to data collected within the stroke register of the Lombardia region in Italy. From our analyses both expected and unexpected results have been found: not always compliance to recommendations is related to a good patients' outcome.
对照随机临床试验和荟萃分析表明,在死亡率、残疾率和依赖程度方面,中风患者受益于进入专门的中风单元。然而,许多与中风诊断和治疗以及中风护理组织相关的问题仍有待解决,对于哪些干预措施能使中风单元更有效知之甚少。人们还一致认为,遵循临床实践指南可改善这些患者的健康结局,但对于不同指南建议的相对权重了解甚少。在过去十年中,许多基于医院或人群的中风登记册已经建立,目的是确定能够监测急性中风护理质量和充分性的特定关键指标。登记册似乎是收集分析护理过程所需数据的适当工具,为国家医疗保健规划和科学研究提供有用数据。在本文中,我们将数据挖掘技术应用于意大利伦巴第地区中风登记册收集的数据。从我们的分析中发现了预期和意外的结果:并非总是遵循建议就会带来良好的患者结局。