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初级和初级保健中的分诊错误。

Triage Errors in Primary and Pre-Primary Care.

机构信息

Your.MD Ltd, London, United Kingdom.

Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.

出版信息

J Med Internet Res. 2022 Jun 24;24(6):e37209. doi: 10.2196/37209.

DOI:10.2196/37209
PMID:35749166
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9270711/
Abstract

Triage errors are a major concern in health care due to resulting harmful delays in treatments or inappropriate allocation of resources. With the increasing popularity of digital symptom checkers in pre-primary care settings, and amid claims that artificial intelligence outperforms doctors, the accuracy of triage by digital symptom checkers is ever more scrutinized. This paper examines the context and challenges of triage in primary care, pre-primary care, and emergency care, as well as reviews existing evidence on the prevalence of triage errors in all three settings. Implications for development, research, and practice are highlighted, and recommendations are made on how digital symptom checkers should be best positioned.

摘要

分诊错误是医疗保健中的一个主要关注点,因为这会导致治疗延误或资源分配不当。随着数字症状检查器在初级保健环境中的日益普及,以及声称人工智能优于医生的说法,数字症状检查器的分诊准确性受到了更多的关注。本文研究了初级保健、初级保健前和急救护理中的分诊背景和挑战,并回顾了所有这三个环境中分诊错误的普遍存在的现有证据。本文强调了对发展、研究和实践的影响,并就数字症状检查器的最佳定位提出了建议。

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本文引用的文献

1
Triage Accuracy of Symptom Checker Apps: 5-Year Follow-up Evaluation.症状检查器应用程序的分诊准确性:5 年随访评估。
J Med Internet Res. 2022 May 10;24(5):e31810. doi: 10.2196/31810.
2
Patient's Perception of Digital Symptom Assessment Technologies in Rheumatology: Results From a Multicentre Study.患者对风湿病数字症状评估技术的认知:一项多中心研究的结果。
Front Public Health. 2022 Feb 22;10:844669. doi: 10.3389/fpubh.2022.844669. eCollection 2022.
3
Agreement and validity of electronic patient self-triage (eTriage) with nurse triage in two UK emergency departments: a retrospective study.电子患者自我分诊(eTriage)与英国两家急诊科护士分诊的一致性和有效性:一项回顾性研究。
Eur J Emerg Med. 2022 Feb 1;29(1):49-55. doi: 10.1097/MEJ.0000000000000863.
4
Accuracy of online symptom checkers and the potential impact on service utilisation.在线症状检查器的准确性及其对服务利用的潜在影响。
PLoS One. 2021 Jul 15;16(7):e0254088. doi: 10.1371/journal.pone.0254088. eCollection 2021.
5
Accuracy, patient-perceived usability, and acceptance of two symptom checkers (Ada and Rheport) in rheumatology: interim results from a randomized controlled crossover trial.两种风湿病症状检查器(Ada和Rheport)的准确性、患者感知的可用性及接受度:一项随机对照交叉试验的中期结果
Arthritis Res Ther. 2021 Apr 13;23(1):112. doi: 10.1186/s13075-021-02498-8.
6
How accurate are digital symptom assessment apps for suggesting conditions and urgency advice? A clinical vignettes comparison to GPs.数字症状评估应用程序在提示病症和紧急程度建议方面的准确性如何?与全科医生进行临床病例比较。
BMJ Open. 2020 Dec 16;10(12):e040269. doi: 10.1136/bmjopen-2020-040269.
7
How accurate is telephone triage in out-of-hours care? An observational trial in real patients.非工作时间的电话分诊有多准确?一项针对真实患者的观察性试验。
Acta Clin Belg. 2022 Apr;77(2):301-306. doi: 10.1080/17843286.2020.1839719. Epub 2020 Oct 30.
8
Comparison of an online self-referral tool with a physician-based referral strategy for early recognition of patients with a high probability of axial spa.在线自我转诊工具与基于医生的转诊策略比较,以早期识别轴向脊柱关节炎高概率患者。
Semin Arthritis Rheum. 2020 Oct;50(5):1015-1021. doi: 10.1016/j.semarthrit.2020.07.018. Epub 2020 Sep 7.
9
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BMC Fam Pract. 2020 May 9;21(1):84. doi: 10.1186/s12875-020-01122-z.
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BMJ. 2020 Mar 18;368:m992. doi: 10.1136/bmj.m992.