Inoue Y
Department of Medical Informatics, Yamaguchi University School of Medicine, Ube.
Rinsho Byori. 1990 May;38(5):587-92.
Decision analysis is a noteworthy methods to solve complex medical problems and select best alternative under uncertainty, and its practical applications in laboratory medicine are anticipated for appropriate usage of laboratory resources. From the view of classical microbiology, it is necessary to identify bacteria causing an infection and select sensitive antibiotics to this pathogen. Decision analysis was used to estimate the clinical and economic implications of microbiological testing for urinary tract infections at the initial visit for all women with acute dysuria. A strategy of initial culture was compared with a strategy involving the use of culture only for patients with symptoms persisting 3 days after initial therapy (wait 3 days strategy). Expected direct cost and medical care days were 10,748 yen and 7.12 days for initial culture strategy and 6872 yen and 7.24 days for wait 3 days strategy. Sensitivity analysis showed that initial culture strategy was not cost effective when the frequency of antibiotics resistant organisms would be increased or required days to obtain microbiological tests results would be decreased.
决策分析是解决复杂医学问题并在不确定性情况下选择最佳方案的一种值得关注的方法，预计其在检验医学中的实际应用将有助于实验室资源的合理利用。从经典微生物学的角度来看，有必要鉴定引起感染的细菌并选择对该病原体敏感的抗生素。决策分析被用于评估对所有急性排尿困难女性初诊时进行尿路感染微生物检测的临床和经济影响。将初始培养策略与仅对初始治疗后症状持续3天的患者使用培养的策略（等待3天策略）进行了比较。初始培养策略的预期直接成本和医疗天数分别为10,748日元和7.12天，等待3天策略为6872日元和7.24天。敏感性分析表明，当抗生素耐药菌的频率增加或获得微生物检测结果所需天数减少时，初始培养策略不具有成本效益。
