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计算机断层扫描前患者病史的结构化数字自我评估:性能评估与附加价值

Structured Digital Self-Assessment of Patient Anamnesis Prior to Computed Tomography: Performance Evaluation and Added Value.

作者信息

Kopp M, Wetzl M, Geissler F, Roth J P, Wallner R, Hoefler D, Faby S, Allmendinger T, Amarteifio P, Wuest W, Cavallaro A, Uder M, May M S

机构信息

Departement of Radiology, University Hospital Erlangen, 91054, Erlangen, Germany.

e.Bavarian Health GmbH, Erlangen, Germany.

出版信息

J Med Syst. 2021 Jan 28;45(3):30. doi: 10.1007/s10916-020-01690-8.

Abstract

The aim of this study was to evaluate the performance of a tablet-based, digitized structured self-assessment (DSSA) of patient anamnesis (PA) prior to computed tomography (CT). Of the 317 patients consecutively referred for CT, the majority (n = 294) was able to complete the tablet-based questionnaire, which consisted of 67 items covering social anamnesis, lifestyle factors (e.g., tobacco abuse), medical history (e.g., kidney diseases), current symptoms, and the usability of the system. Patients were able to mark unclear questions for a subsequent discussion with the radiologist. Critical issues for the CT examination were structured and automatically highlighted as "red flags" (RFs) in order to improve patient interaction. RFs and marked questions were highly prevalent (69.5% and 26%). Missing creatinine values (33.3%), kidney diseases (14.4%), thyroid diseases (10.6%), metformin (5.5%), claustrophobia (4.1%), allergic reactions to contrast agents (2.4%), and pathological TSH values (2.0%) were highlighted most frequently as RFs. Patient feedback regarding the comprehensibility of the questionnaire and the tablet usability was mainly positive (90.9%; 86.2%). With advanced age, however, patients provided more negative feedback for both (p = 0.007; p = 0.039). The time effort was less than 20 min for 85.1% of patients, and faster patients were significantly younger (p = 0.046). Overall, the DSSA of PA prior to CT shows a high success rate and is well accepted by most patients. RFs and marked questions were common and helped to focus patients' interactions and reporting towards decisive aspects.

摘要

本研究的目的是评估在计算机断层扫描(CT)之前基于平板电脑的患者病史数字化结构化自我评估(DSSA)的性能。在连续转诊进行CT检查的317例患者中,大多数(n = 294)能够完成基于平板电脑的问卷,该问卷包含67个项目,涵盖社会病史、生活方式因素(如烟草滥用)、病史(如肾脏疾病)、当前症状以及系统的可用性。患者能够标记不清楚的问题以便随后与放射科医生讨论。为了改善患者互动,将CT检查的关键问题进行结构化并自动突出显示为“红旗”(RFs)。RFs和标记问题非常普遍(分别为69.5%和26%)。肌酐值缺失(33.3%)、肾脏疾病(14.4%)、甲状腺疾病(10.6%)、二甲双胍(5.5%)、幽闭恐惧症(4.1%)、对造影剂的过敏反应(2.4%)以及病理性促甲状腺激素值(2.0%)最常被突出显示为RFs。患者对问卷的可理解性和平板电脑可用性的反馈主要是积极的(分别为90.9%;86.2%)。然而,随着年龄增长,患者对这两方面的负面反馈更多(p = 0.007;p = 0.039)。85.1%的患者花费的时间少于20分钟,速度较快的患者明显更年轻(p = 0.046)。总体而言,CT之前的患者病史DSSA成功率很高,并且大多数患者都能很好地接受。RFs和标记问题很常见,有助于将患者的互动和报告聚焦于决定性方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c2a/7843739/fea6bf7d7961/10916_2020_1690_Fig1_HTML.jpg

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