Harrison Andrew M, Yadav Hemang, Pickering Brian W, Cartin-Ceba Rodrigo, Herasevich Vitaly
Medical Scientist Training Program, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA ; Multidisciplinary Epidemiology and Translational Research in Intensive Care (METRIC), Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA.
Crit Care Res Pract. 2013;2013:975672. doi: 10.1155/2013/975672. Epub 2013 Jul 9.
Purpose. To validate the use of a computer program for the automatic calculation of the sequential organ failure assessment (SOFA) score, as compared to the gold standard of manual chart review. Materials and Methods. Adult admissions (age > 18 years) to the medical ICU with a length of stay greater than 24 hours were studied in the setting of an academic tertiary referral center. A retrospective cross-sectional analysis was performed using a derivation cohort to compare automatic calculation of the SOFA score to the gold standard of manual chart review. After critical appraisal of sources of disagreement, another analysis was performed using an independent validation cohort. Then, a prospective observational analysis was performed using an implementation of this computer program in AWARE Dashboard, which is an existing real-time patient EMR system for use in the ICU. Results. Good agreement between the manual and automatic SOFA calculations was observed for both the derivation (N=94) and validation (N=268) cohorts: 0.02 ± 2.33 and 0.29 ± 1.75 points, respectively. These results were validated in AWARE (N=60). Conclusion. This EMR-based automatic tool accurately calculates SOFA scores and can facilitate ICU decisions without the need for manual data collection. This tool can also be employed in a real-time electronic environment.
目的。与手工查阅病历这一金标准相比，验证一种用于自动计算序贯器官衰竭评估（SOFA）评分的计算机程序的实用性。材料与方法。在一所学术性三级转诊中心，对入住内科重症监护病房（ICU）且住院时间超过24小时的成年患者（年龄>18岁）进行研究。使用一个推导队列进行回顾性横断面分析，以将SOFA评分的自动计算结果与手工查阅病历这一金标准进行比较。在对分歧来源进行严格评估后，使用一个独立验证队列进行了另一项分析。然后，在AWARE仪表板中使用该计算机程序的一个实施方案进行了前瞻性观察分析，AWARE仪表板是一种现有的用于ICU的实时患者电子病历系统。结果。在推导队列（N = 94）和验证队列（N = 268）中，手工计算和自动计算的SOFA评分之间均观察到良好的一致性：分别为0.02±2.33分和0.29±1.75分。这些结果在AWARE（N = 60）中得到了验证。结论。这种基于电子病历的自动工具能够准确计算SOFA评分，无需人工收集数据即可辅助ICU决策。该工具也可在实时电子环境中使用。
