Calvert Jacob, Hoffman Jana, Barton Christopher, Shimabukuro David, Ries Michael, Chettipally Uli, Kerem Yaniv, Jay Melissa, Mataraso Samson, Das Ritankar
a Dascena Inc. , Hayward , CA , USA.
b Department of Emergency Medicine , University of California San Francisco , San Francisco , CA , USA.
J Med Econ. 2017 Jun;20(6):646-651. doi: 10.1080/13696998.2017.1307203. Epub 2017 Apr 3.
To compute the financial and mortality impact of InSight, an algorithm-driven biomarker, which forecasts the onset of sepsis with minimal use of electronic health record data.
This study compares InSight with existing sepsis screening tools and computes the differential life and cost savings associated with its use in the inpatient setting. To do so, mortality reduction is obtained from an increase in the number of sepsis cases correctly identified by InSight. Early sepsis detection by InSight is also associated with a reduction in length-of-stay, from which cost savings are directly computed.
InSight identifies more true positive cases of severe sepsis, with fewer false alarms, than comparable methods. For an individual ICU with 50 beds, for example, it is determined that InSight annually saves 75 additional lives and reduces sepsis-related costs by $560,000.
InSight performance results are derived from analysis of a single-center cohort. Mortality reduction results rely on a simplified use case, which fixes prediction times at 0, 1, and 2 h before sepsis onset, likely leading to under-estimates of lives saved. The corresponding cost reduction numbers are based on national averages for daily patient length-of-stay cost.
InSight has the potential to reduce sepsis-related deaths and to lead to substantial cost savings for healthcare facilities.
计算InSight(一种算法驱动的生物标志物)的财务影响和死亡率影响,该生物标志物在最少使用电子健康记录数据的情况下预测脓毒症的发作。
本研究将InSight与现有的脓毒症筛查工具进行比较,并计算其在住院环境中使用所带来的不同生命和成本节约。为此,通过InSight正确识别的脓毒症病例数量增加来实现死亡率降低。InSight对脓毒症的早期检测还与住院时间缩短相关,由此可直接计算成本节约。
与可比方法相比,InSight能识别出更多严重脓毒症的真阳性病例,且误报更少。例如,对于一个拥有50张床位的单个重症监护病房,确定InSight每年可多挽救75条生命,并将脓毒症相关成本降低56万美元。
InSight的性能结果来自单中心队列分析。死亡率降低结果依赖于一个简化的用例,该用例将预测时间固定在脓毒症发作前0、1和2小时,可能导致对挽救生命数量的低估。相应的成本降低数字基于每日患者住院时间成本的全国平均水平。
InSight有可能降低脓毒症相关死亡,并为医疗机构带来可观的成本节约。