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AMIA Annu Symp Proc. 2022 Feb 21;2021:1129-1138. eCollection 2021.
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A Machine Learning-Based Triage Tool for Children With Acute Infection in a Low Resource Setting.基于机器学习的资源匮乏环境下急性感染儿童分诊工具
Pediatr Crit Care Med. 2019 Dec;20(12):e524-e530. doi: 10.1097/PCC.0000000000002121.
2
Development and Validation of a Predictive Model of the Risk of Pediatric Septic Shock Using Data Known at the Time of Hospital Arrival.利用到达医院时已知的数据开发和验证儿科感染性休克风险的预测模型。
J Pediatr. 2020 Feb;217:145-151.e6. doi: 10.1016/j.jpeds.2019.09.079. Epub 2019 Nov 13.
3
The implementation of an electronic health record: Comparing preparations for Epic in Norway with experiences from the UK and Denmark.电子健康记录的实施:比较挪威准备采用 Epic 系统与英国和丹麦的经验。
Int J Med Inform. 2019 Sep;129:312-317. doi: 10.1016/j.ijmedinf.2019.06.026. Epub 2019 Jun 26.
4
A clinical decision support system to improve adequate dosing of gentamicin and vancomycin.一个用于改善庆大霉素和万古霉素适当剂量的临床决策支持系统。
Int J Med Inform. 2019 Apr;124:1-5. doi: 10.1016/j.ijmedinf.2019.01.002. Epub 2019 Jan 2.
5
Automating a Manual Sepsis Screening Tool in a Pediatric Emergency Department.在儿科急诊室中自动化手动脓毒症筛查工具。
Appl Clin Inform. 2018 Oct;9(4):803-808. doi: 10.1055/s-0038-1675211. Epub 2018 Oct 31.
6
Association Between the New York Sepsis Care Mandate and In-Hospital Mortality for Pediatric Sepsis.纽约脓毒症护理指令与儿科脓毒症院内死亡率的关联
JAMA. 2018 Jul 24;320(4):358-367. doi: 10.1001/jama.2018.9071.
7
Automated monitoring compared to standard care for the early detection of sepsis in critically ill patients.与标准护理相比,自动监测用于危重症患者脓毒症的早期检测
Cochrane Database Syst Rev. 2018 Jun 25;6(6):CD012404. doi: 10.1002/14651858.CD012404.pub2.
8
Improving Recognition of Pediatric Severe Sepsis in the Emergency Department: Contributions of a Vital Sign-Based Electronic Alert and Bedside Clinician Identification.提高急诊科对儿童严重脓毒症的识别能力:基于生命体征的电子警报和床边临床医生识别的作用
Ann Emerg Med. 2017 Dec;70(6):759-768.e2. doi: 10.1016/j.annemergmed.2017.03.019. Epub 2017 Jun 2.
9
Association of Delayed Antimicrobial Therapy with One-Year Mortality in Pediatric Sepsis.小儿脓毒症延迟抗菌治疗与一年死亡率的关联
Shock. 2017 Jul;48(1):29-35. doi: 10.1097/SHK.0000000000000833.
10
Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016.拯救脓毒症运动:脓毒症和脓毒性休克管理国际指南:2016 年版。
Intensive Care Med. 2017 Mar;43(3):304-377. doi: 10.1007/s00134-017-4683-6. Epub 2017 Jan 18.

从分诊时可获得的数据预测儿科脓毒症的复苏。

Prediction of Resuscitation for Pediatric Sepsis from Data Available at Triage.

机构信息

Department of Pediatrics, NYU Grossman School of Medicine, New York.

Department of Emergency Medicine, NYU Grossman School of Medicine, New York.

出版信息

AMIA Annu Symp Proc. 2022 Feb 21;2021:1129-1138. eCollection 2021.

PMID:35308977
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8861694/
Abstract

Pediatric sepsis imposes a significant burden of morbidity and mortality among children. While the speedy application of existing supportive care measures can substantially improve outcomes, further improvements in delivering that care require tools that go beyond recognizing sepsis and towards predicting its development. Machine learning techniques have great potential as predictive tools, but their application to pediatric sepsis has been stymied by several factors, particularly the relative rarity of its occurrence. We propose an alternate approach which focuses on predicting the provision of resuscitative care, rather than sepsis diagnoses or criteria themselves. Using three years of Emergency Department data from a large academic medical center, we developed a boosted tree model that predicts resuscitation within 6 hours of triage, and significantly outperforms existing rule-based sepsis alerts.

摘要

儿科脓毒症给儿童带来了重大的发病和死亡负担。虽然迅速应用现有的支持性护理措施可以显著改善预后,但要进一步提高护理质量,就需要超越识别脓毒症并预测其发展的工具。机器学习技术具有成为预测工具的巨大潜力,但由于多种因素,它们在儿科脓毒症中的应用受到了阻碍,特别是该病症相对罕见。我们提出了一种替代方法,该方法侧重于预测复苏治疗的提供,而不是脓毒症的诊断或标准本身。我们使用来自一家大型学术医疗中心的三年急诊数据,开发了一个增强树模型,可预测分诊后 6 小时内的复苏,并显著优于现有的基于规则的脓毒症警报。