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单纯性膀胱炎的物理治疗与数字治疗及记录的比较

Comparison of Physical and Digital Treatment and Documentation of Uncomplicated Cystitis.

作者信息

Al-Saadi Jonathan, Grönholdt Klein Max, Ilicki Jonathan J, Djarv Therese

机构信息

Clinical Neuroscience, Karolinska University Hosptal, Stockholm, SWE.

Medical Content, Platform24, Stockholm, SWE.

出版信息

Cureus. 2021 Aug 21;13(8):e17342. doi: 10.7759/cureus.17342. eCollection 2021 Aug.

Abstract

Introduction Symptomatic criteria have a diagnostic specificity of approximately 90% for uncomplicated cystitis. Today there are triage bots that can collect patient history and document simultaneously. Acute uncomplicated cystitis could potentially be managed digitally, due to the symptom-based approach to diagnosis, but no studies have yet validated this approach. Aim We determined the extent of criteria documentation and evaluated adherence to antibiotic recommendations in order to compare physical and digital patient consultations for uncomplicated cystitis. Materials and methods This cross-sectional study recruited sixteen 50-year-old women who presented with urinary symptoms to digital healthcare or to three primary physical healthcare facilities. The primary endpoint was the proportion of patients who had two or more documented criteria and received correct antibiotic treatment. Results In total, 307 patient visits were included in the study (278 in the digital arm and 40 in the physical arm). The proportion of patients who had two or more documented diagnostic criteria and correct treatment was significantly higher in the digital arm (96 vs 81.6 %, p < 0.001). The total proportion of patients who had fully documented diagnostic criteria did not differ significantly between the arms, however, the proportion with two or more documented criteria was significantly higher in the digital arm (95 vs 77.5%, p < 0.001). The proportion of treated patients who had documented exclusion of diagnostic complicating factors was higher in the digital arm (85.5 vs 0%, p < 0.001). Conclusions More patients with urinary tract infection (UTI) now seek digital healthcare providers who have similar or better adherence to antibiotic treatment recommendations and documentation.

摘要

引言

症状标准对单纯性膀胱炎的诊断特异性约为90%。如今有分诊机器人可以同时收集患者病史并进行记录。由于基于症状的诊断方法,急性单纯性膀胱炎有可能通过数字化方式进行管理,但尚无研究验证这种方法。

目的

我们确定了标准记录的程度,并评估了对抗生素推荐的依从性,以便比较单纯性膀胱炎患者面对面诊疗和数字化诊疗的情况。

材料与方法

这项横断面研究招募了16名50岁出现泌尿系统症状的女性,她们前往数字化医疗保健机构或三家基层实体医疗保健机构就诊。主要终点是有两条或更多记录标准并接受正确抗生素治疗的患者比例。

结果

该研究共纳入307次患者就诊(数字化诊疗组278次,面对面诊疗组40次)。在数字化诊疗组中,有两条或更多记录诊断标准且治疗正确的患者比例显著更高(96%对81.6%,p<0.001)。两组之间完全记录诊断标准的患者总比例没有显著差异,然而,数字化诊疗组中有两条或更多记录标准的患者比例显著更高(95%对77.5%,p<0.001)。在数字化诊疗组中,记录排除诊断复杂因素的治疗患者比例更高(85.5%对0%,p<0.001)。

结论

现在更多的尿路感染(UTI)患者寻求数字化医疗服务提供者,他们对抗生素治疗建议和记录的依从性相似或更好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/356c/8450688/47366e647e1b/cureus-0013-00000017342-i01.jpg

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