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在资源有限的环境中,确定 5 岁以下儿童分诊时脓毒症的预测因素:一项改良德尔菲法研究。

Determining predictors of sepsis at triage among children under 5 years of age in resource-limited settings: A modified Delphi process.

机构信息

Centre for International Child Health, BC Children's Hospital, Vancouver, BC, Canada.

Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.

出版信息

PLoS One. 2019 Jan 28;14(1):e0211274. doi: 10.1371/journal.pone.0211274. eCollection 2019.

Abstract

Sepsis is a life-threatening dysfunction of the immune system leading to multiorgan failure that is precipitated by infectious diseases and is a leading cause of death in children under 5 years of age. It is necessary to be able to identify a sick child at risk of developing sepsis at the earliest point of presentation to a healthcare facility so that appropriate care can be provided as soon as possible. Our study objective was to generate a list of consensus-driven predictor variables for the derivation of a prediction model that will be incorporated into a mobile device and operated by low-skilled healthcare workers at triage. By conducting a systematic literature review and examination of global guideline documents, a list of 72 initial candidate predictor variables was generated. A two-round modified Delphi process involving 26 experts from both resource-rich and resource-limited settings, who were also encouraged to suggest new variables, yielded a final list of 45 predictor variables after evaluating each variable based on three domains: predictive potential, measurement reliability, and level of training and resources required. The final list of predictor variables will be used to collect data and contribute to the derivation of a prediction model.

摘要

败血症是一种危及生命的免疫系统功能障碍,可导致多器官衰竭,由传染病引发,是 5 岁以下儿童死亡的主要原因。在儿童前往医疗机构就诊的最早时刻,必须能够识别出有败血症风险的患病儿童,以便尽快提供适当的护理。我们的研究目的是生成一组基于共识的预测变量清单,以便推导出一个预测模型,该模型将被纳入移动设备中,并由分诊时技能水平较低的医疗保健工作者操作。通过进行系统的文献回顾和全球指南文件的检查,生成了一份 72 个初始候选预测变量的清单。两轮改良德尔菲法涉及来自资源丰富和资源有限环境的 26 名专家,他们还被鼓励提出新的变量,在根据三个领域评估每个变量后:预测潜力、测量可靠性以及所需的培训和资源水平,最终得到了 45 个预测变量的清单。最终的预测变量清单将用于收集数据,并有助于推导出预测模型。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70d3/6349330/4e8c96e97c9d/pone.0211274.g001.jpg

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