Clamp S E, Morgan A G, Kotwal M R, Hu F L, Li T L, Chen M C, Malizia G, de Dombal F T
Airedale General Hospital, West Yorkshire, England.
Scand J Gastroenterol Suppl. 1988;144:63-6.
The OMGE multinational survey of patients with upper gastrointestinal bleeding demonstrated that it was possible to predict patient outcome, using a computer and a database of information from many centres. It remained to be seen whether this database could be used in specific remote areas of the world. To answer this question, two areas have been studied, Sikkim and China. In Sikkim, when the computer-aided prognostic system was used, 69% of patients put into a high-risk group for rebleeding actually did so; and 54% died. By contrast, only 2% of patients placed into a low-risk group for rebleeding did so. As there is little computer technology in Sikkim, a simplified scoring system was developed which gave the same predictive accuracy as the computer system. In China there was a slightly lower accuracy with both systems. Hence a new database and scoring system were created, using only information from Chinese patients. This database improved the results. From the studies it is suggested that these types of systems can be of value to patients in remote areas by targeting patients at high risk rebleeding or dying, so that the scarce resources available can be best used.
OMGE关于上消化道出血患者的跨国调查表明，利用计算机和来自多个中心的信息数据库能够预测患者的预后情况。该数据库是否能在世界上特定的偏远地区使用还有待观察。为了回答这个问题，研究了两个地区，锡金和中国。在锡金，当使用计算机辅助预后系统时，被归入再出血高危组的患者中，实际发生再出血的占69%；死亡的占54%。相比之下，被归入再出血低危组的患者中，只有2%发生了再出血。由于锡金几乎没有计算机技术，于是开发了一种简化评分系统，其预测准确性与计算机系统相同。在中国，两种系统的准确性略低。因此，仅使用中国患者的信息创建了一个新的数据库和评分系统。这个数据库改善了结果。从这些研究可以看出，这类系统通过针对再出血或死亡高危患者，对偏远地区的患者可能具有价值，从而可以最佳地利用现有的稀缺资源。
