Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
J Travel Med. 2011 Nov-Dec;18(6):386-94. doi: 10.1111/j.1708-8305.2011.00566.x. Epub 2011 Oct 14.
KABISA TRAVEL is a clinical decision support system developed by the Institute of Tropical Medicine of Antwerp, Belgium, for the diagnosis of febrile illnesses after a stay in the tropics. This study aimed to compare the diagnostic accuracy of KABISA TRAVEL with that of expert travel physicians.
From December 2007 to April 2009, travelers with fever after a stay in the tropics were included in a multicenter trial conducted in travel referral centers in the Netherlands, Italy, Spain, and Belgium. Physicians were asked (1) to rank their first assessment diagnoses, (2) to enter in KABISA TRAVEL clinical and laboratory data available within 36 hours, and (3) to interact with the tutor until its final diagnostic ranking. Both physicians and KABISA TRAVEL rankings were then compared with the final diagnosis confirmed by reference methods. The clinical utility was also surveyed.
A total of 205 cases with confirmed diagnosis were evaluated (male/female ratio: 1.85; mean age: 35 y). Most patients were western travelers or expatriates (60%) and were returning from sub-Saharan Africa (58%). Travel physicians and KABISA TRAVEL ranked the correct diagnosis in the first place for 70 and 72% of the cases, respectively, and within the top five both for 88% of them. Travel physicians reported having been suggested useful further investigations in 16% of the cases, and having been helped for obtaining the diagnosis in 24%. This was reported more frequently when they had initially missed the diagnosis (suggestion: 48% in missed vs 12% in found diagnoses, p < 0.001; helpful: 48% in missed vs 21% in found diagnoses, p = 0.005).
KABISA TRAVEL performed as well as expert travel physicians in diagnosing febrile illnesses occurring after a tropical stay. Clinicians perceived the system as more helpful when they had not immediately considered the correct diagnosis.
KABISA TRAVEL 是由比利时安特卫普热带医学研究所开发的一种临床决策支持系统，用于诊断在热带地区逗留后出现的发热疾病。本研究旨在比较 KABISA TRAVEL 与旅行医学专家的诊断准确性。
2007 年 12 月至 2009 年 4 月，在荷兰、意大利、西班牙和比利时的旅行转诊中心进行了一项多中心试验，纳入了在热带地区逗留后发热的旅行者。医生被要求（1）对其首次评估诊断进行排名，（2）在 36 小时内输入 KABISA TRAVEL 临床和实验室数据，（3）与导师进行互动，直到其最终诊断排名。然后将医生和 KABISA TRAVEL 的排名与参考方法确认的最终诊断进行比较。还调查了临床实用性。
共评估了 205 例确诊病例（男/女比例：1.85；平均年龄：35 岁）。大多数患者是西方旅行者或外籍人士（60%），并从撒哈拉以南非洲（58%）返回。旅行医生和 KABISA TRAVEL 分别将正确诊断排在首位的病例分别为 70%和 72%，而排在前五位的病例均为 88%。旅行医生报告说，在 16%的病例中建议进行进一步有用的检查，在 24%的病例中有助于诊断。当他们最初错过诊断时，这种情况更为常见（建议：在漏诊病例中为 48%，在确诊病例中为 12%，p <0.001；有帮助：在漏诊病例中为 48%，在确诊病例中为 21%，p=0.005）。
KABISA TRAVEL 在诊断热带地区逗留后发生的发热疾病方面与旅行医学专家一样出色。当临床医生没有立即考虑正确诊断时，他们认为该系统更有帮助。
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