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用于识别有阿片类物质使用障碍风险的住院成年人的电子健康记录嵌入式人工智能筛查工具的结果及成本效益

Outcomes and Cost-Effectiveness of an EHR-Embedded AI Screener for Identifying Hospitalized Adults at Risk for Opioid Use Disorder.

作者信息

Afshar Majid, Resnik Felice, Joyce Cara, Oguss Madeline, Dligach Dmitriy, Burnside Elizabeth, Sullivan Anne, Churpek Matthew, Patterson Brian, Salisbury-Afshar Elizabeth, Liao Frank, Brown Randall, Mundt Marlon

机构信息

University of Wisconsin - Madison.

Loyola University Chicago Stritch School of Medicine.

出版信息

Res Sq. 2024 Oct 14:rs.3.rs-5200964. doi: 10.21203/rs.3.rs-5200964/v1.

Abstract

UNLABELLED

Hospitalized adults with opioid use disorder (OUD) are at high risk for adverse events and rehospitalizations. This pre-post quasi-experimental study evaluated whether an AI-driven OUD screener embedded in the electronic health record (EHR) was non-inferior to usual care in identifying patients for Addiction Medicine consults, aiming to provide a similarly effective but more scalable alternative to human-led ad hoc consultations. The AI screener analyzed EHR notes in real-time with a convolutional neural network to identify patients at risk and recommend consultation. The primary outcome was the proportion of patients receiving consults, comparing a 16-month pre-intervention period to an 8-month post-intervention period with the AI screener. Consults did not change between periods (1.35% vs 1.51%, p < 0.001 for non-inferiority). The AI screener was associated with a reduction in 30-day readmissions (OR: 0.53, 95% CI: 0.30-0.91, p = 0.02) with an incremental cost of $6,801 per readmission avoided, demonstrating its potential as a scalable, cost-effective solution for OUD care.

CLINICALTRIALSGOV ID

NCT05745480.

摘要

未标注

患有阿片类物质使用障碍(OUD)的住院成年人发生不良事件和再次住院的风险很高。这项前后对照的准实验研究评估了嵌入电子健康记录(EHR)中的人工智能驱动的OUD筛查工具在识别需要成瘾医学咨询的患者方面是否不劣于常规护理,旨在提供一种同样有效但更具可扩展性的替代方案,以取代人工主导的临时咨询。人工智能筛查工具使用卷积神经网络实时分析EHR记录,以识别有风险的患者并推荐咨询。主要结局是接受咨询的患者比例,比较了使用人工智能筛查工具的16个月干预前期和8个月干预后期。两个时期之间的咨询情况没有变化(1.35%对1.51%,非劣效性p<0.001)。人工智能筛查工具与30天再入院率的降低相关(比值比:0.53,95%置信区间:0.30 - 0.91,p = 0.02),避免每次再入院的增量成本为6801美元,证明了其作为OUD护理的可扩展、具有成本效益的解决方案的潜力。

临床试验注册号

NCT05745480。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b2b/11527233/c8eead598bbe/nihpp-rs5200964v1-f0001.jpg

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