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AMIA Annu Symp Proc. 2018 Dec 5;2018:1076-1083. eCollection 2018.
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Association of the Hospital Readmissions Reduction Program Implementation With Readmission and Mortality Outcomes in Heart Failure.医院再入院率降低计划实施与心力衰竭患者再入院和死亡率结局的关联。
JAMA Cardiol. 2018 Jan 1;3(1):44-53. doi: 10.1001/jamacardio.2017.4265.
2
Economic burden of hospitalizations of Medicare beneficiaries with heart failure.医疗保险受益人心力衰竭住院的经济负担。
Risk Manag Healthc Policy. 2017 May 10;10:63-70. doi: 10.2147/RMHP.S130341. eCollection 2017.
3
Analysis of Machine Learning Techniques for Heart Failure Readmissions.心力衰竭再入院的机器学习技术分析
Circ Cardiovasc Qual Outcomes. 2016 Nov;9(6):629-640. doi: 10.1161/CIRCOUTCOMES.116.003039. Epub 2016 Nov 8.
4
Prediction of 30-Day All-Cause Readmissions in Patients Hospitalized for Heart Failure: Comparison of Machine Learning and Other Statistical Approaches.预测因心力衰竭住院患者的 30 天全因再入院率:机器学习与其他统计学方法的比较。
JAMA Cardiol. 2017 Feb 1;2(2):204-209. doi: 10.1001/jamacardio.2016.3956.
5
Trends in 30-Day Readmission Rates for Patients Hospitalized With Heart Failure: Findings From the Get With The Guidelines-Heart Failure Registry.心力衰竭住院患者30天再入院率趋势:来自“遵循指南-心力衰竭注册研究”的结果
Circ Heart Fail. 2016 Jun;9(6). doi: 10.1161/CIRCHEARTFAILURE.115.002594.
6
The Prevention of Hospital Readmissions in Heart Failure.心力衰竭患者再入院的预防
Prog Cardiovasc Dis. 2016 Jan-Feb;58(4):379-85. doi: 10.1016/j.pcad.2015.09.004. Epub 2015 Oct 21.
7
Why the C-statistic is not informative to evaluate early warning scores and what metrics to use.为何C统计量对于评估早期预警评分并无参考价值以及应使用何种指标。
Crit Care. 2015 Aug 13;19(1):285. doi: 10.1186/s13054-015-0999-1.
8
Derivation and validation of a 30-day heart failure readmission model.一种30天心力衰竭再入院模型的推导与验证
Am J Cardiol. 2014 Nov 1;114(9):1379-82. doi: 10.1016/j.amjcard.2014.07.071. Epub 2014 Aug 12.
9
A path forward on Medicare readmissions.医疗保险再入院问题的解决之道。
N Engl J Med. 2013 Mar 28;368(13):1175-7. doi: 10.1056/NEJMp1300122. Epub 2013 Mar 6.
10
Risk prediction models for hospital readmission: a systematic review.医院再入院风险预测模型:系统评价。
JAMA. 2011 Oct 19;306(15):1688-98. doi: 10.1001/jama.2011.1515.

交互式成本效益分析:为预测分析提供实际财务背景。

Interactive Cost-benefit Analysis: Providing Real-World Financial Context to Predictive Analytics.

作者信息

Weiner Mark G, Sheikh Wasiq, Lehmann Harold P

机构信息

Lewis Katz School of Medicine at Temple University, Philadelphia, PA.

The Johns Hopkins University School of Medicine, Baltimore, MD.

出版信息

AMIA Annu Symp Proc. 2018 Dec 5;2018:1076-1083. eCollection 2018.

PMID:30815149
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6371360/
Abstract

Clinical implementation of predictive analytics that assess risk of high-cost outcomes are presumed to save money because they help focus interventions designed to avert those outcomes on a subset patients who are most likely to benefit from the intervention. This premise may not always be true. A cost-benefit analysis is necessary to show if a strategy of applying the predictive algorithm is truly favorable to alternative strategies. We designed and implemented an interactive web-based cost-benefit calculator, enabling specification of accuracy parameters for the predictive model and other clinical and financial factors related to the occurrence of an undesirable outcome. We use the web tool, populated with real-world data to illustrate a cost-benefit analysis of a strategy of applying predictive analytics to select a cohort of high-risk patients to receive interventions to avert readmissions for Congestive Heart Failure (CHF). Application of predictive analytics in clinical care may not always be a cost-saving strategy compared with intervening on all patients. Improving the accuracy of a predictive model may lower costs, but other factors such as the prevalence and cost of the outcome, and the cost and effectiveness of the intervention designed to avert the outcome may be more influential in determining the favored strategy. An interactive cost-benefit analyses provides insights regarding the financial implications of a clinical strategy that implements predictive analytics.

摘要

评估高成本结局风险的预测分析在临床中的应用被认为能够节省资金,因为它们有助于将旨在避免这些结局的干预措施集中于最有可能从干预中受益的一部分患者身上。但这一前提并非总是成立。有必要进行成本效益分析,以表明应用预测算法的策略是否真的优于其他替代策略。我们设计并实现了一个基于网络的交互式成本效益计算器,可设定预测模型的准确性参数以及与不良结局发生相关的其他临床和财务因素。我们使用这个填充了真实世界数据的网络工具,来说明对应用预测分析策略以选择一组高危患者接受干预以避免充血性心力衰竭(CHF)再入院的策略进行成本效益分析的情况。与对所有患者进行干预相比,在临床护理中应用预测分析可能并不总是一种节省成本的策略。提高预测模型的准确性可能会降低成本,但其他因素,如结局的发生率和成本,以及旨在避免该结局的干预措施的成本和效果,在确定首选策略时可能更具影响力。交互式成本效益分析为实施预测分析的临床策略的财务影响提供了见解。