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创建交互式仪表板以促进非裔美国退伍军人心脏淀粉样变性的早期检测。

Creation of an Interactive Dashboard to Facilitate Early Detection of Cardiac Amyloidosis in African American Veterans.

作者信息

Ghannam Hamza, Singh Vikram, Warner Alberta L, Powell Ariel, Gelzer Bell Ramona, Chow Kevin, Braswell Kimberly D, Hearns Rene, Aggarwal Vinod, Roy Celina, Stoehr Douglas, Guzman-Clark Jenice, Dev Sandesh

机构信息

University of Arizona College of Medicine, Tucson, Arizona, United States.

Department of Cardiology, VA Greater Los Angeles Healthcare System, David Geffen School of Medicine at UCLA, Los Angeles, California, United States.

出版信息

Appl Clin Inform. 2025 Mar;16(2):429-438. doi: 10.1055/a-2513-9400. Epub 2025 May 14.

Abstract

BACKGROUND

Cardiac amyloidosis (CA) is an underdiagnosed cause of heart failure (HF) that disproportionately impacts men of African descent. Without a standardized method of screening and scattered patient health information, clinicians must integrate data that spans multiple disease systems and is stored across the electronic health record.

OBJECTIVES

The aim of this project was to create a dashboard to facilitate identification of high-risk African American (AA) veterans who would benefit from CA screening tests. This paper described the development of the dashboard and identified barriers and opportunities in dashboard development.

METHODS

Three Veterans Affairs (VA) health systems participated in this project. Microsoft Structured Query Language (SQL) Report Builder was utilized to create an interactive dashboard that refreshes daily through stored procedures using SQL Server Integration Services and the SQL Server Job Agent. Inclusion criteria included AA patients less than 90 years old with a history of HF. The 2023 American College of Cardiology/American Heart Association consensus statement on diagnosis and treatment of transthyretin CA was the source of evidence in creating the inclusion criteria and parameters of interest.

RESULTS

The final dashboard contained 1,732 HF patients who met inclusion criteria, of which 949 (55%) were identified as high risk. We faced several challenges in this project, including time required for dashboard development, limited team experience in specifying dashboard requirements, identifying informatics counterparts at all sites, and standardizing data across three VA hospitals.

CONCLUSION

In this clinical improvement project, we created a dashboard that identifies AA veterans with HF at risk for CA and that can help to mitigate the impact of CA on this population.

摘要

背景

心脏淀粉样变性(CA)是心力衰竭(HF)的一个诊断不足的病因,对非洲裔男性的影响尤为严重。由于缺乏标准化的筛查方法且患者健康信息分散,临床医生必须整合跨越多个疾病系统并存储在电子健康记录中的数据。

目的

本项目的目的是创建一个仪表板,以促进识别可能从CA筛查测试中受益的高危非裔美国(AA)退伍军人。本文描述了仪表板的开发过程,并确定了仪表板开发中的障碍和机遇。

方法

三个退伍军人事务(VA)医疗系统参与了本项目。利用微软结构化查询语言(SQL)报表生成器创建了一个交互式仪表板,该仪表板通过使用SQL Server集成服务和SQL Server作业代理的存储过程每天刷新。纳入标准包括年龄小于90岁且有HF病史的AA患者。2023年美国心脏病学会/美国心脏协会关于转甲状腺素蛋白CA诊断和治疗的共识声明是制定纳入标准和感兴趣参数的证据来源。

结果

最终仪表板包含1732名符合纳入标准的HF患者,其中949名(55%)被确定为高危患者。我们在这个项目中面临了几个挑战——仪表板开发所需的时间、团队在明确仪表板要求方面经验有限、在所有站点识别信息学对应人员以及在三家VA医院标准化数据。

结论

在这个临床改进项目中,我们创建了一个仪表板,用于识别有CA风险的HF AA退伍军人,并有助于减轻CA对该人群的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0748/12077983/5cafbcb08669/10-1055-a-2513-9400-i202407ra0233-1.jpg

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