den Brinker Albertus C, Thackray-Nocera Susannah, Crooks Michael G, Morice Alyn H
Independent Researcher, NL-5708 DJ Helmond, The Netherlands.
Centre for Clinical Science, Hull York Medical School, University of Hull, Cottingham HU16 5JQ, UK.
J Pers Med. 2025 Aug 2;15(8):349. doi: 10.3390/jpm15080349.
Targeting individuals with certain characteristics provides improved precision in many healthcare applications. An alert mechanism for COPD exacerbations has recently been validated. It has been argued that its efficacy improves considerably with stratification. This paper provides an in-depth analysis of the cough data of the stratified cohort to identify options for and the feasibility of improved precision in the alert mechanism for the intended patient group. The alert system was extended using a system complementary to the existing one to accommodate observed rapid changes in cough trends. The designed system was tested in a post hoc analysis of the data. The trend data were inspected to consider their meaningfulness for patients and caregivers. While stratification was effective in reducing misses, the augmented alert system improved the sensitivity and number of early alerts for the acute exacerbation of COPD (AE-COPD). The combination of stratification and the augmented mechanism led to sensitivity of 86%, with a false alert rate in the order of 1.5 per year in the target group. The alert system is rule-based, operating on interpretable signals that may provide patients or their caregivers with better insights into the respiratory condition. The augmented alert system operating based on cough trends has the promise of increased precision in detecting AE-COPD in the target group. Since the design and testing of the augmented system were based on the same data, the system needs to be validated. Signals within the alert system are potentially useful for improved self-management in the target group.
针对具有某些特征的个体在许多医疗保健应用中可提高精准度。一种慢性阻塞性肺疾病（COPD）急性加重的警报机制最近已得到验证。有人认为，通过分层，其功效会显著提高。本文对分层队列的咳嗽数据进行了深入分析，以确定针对目标患者群体提高警报机制精准度的选项及其可行性。警报系统通过使用与现有系统互补的系统进行扩展，以适应观察到的咳嗽趋势的快速变化。所设计的系统在数据的事后分析中进行了测试。对趋势数据进行了检查，以考虑其对患者和护理人员的意义。虽然分层在减少漏报方面有效，但增强型警报系统提高了慢性阻塞性肺疾病急性加重（AE-COPD）早期警报的敏感性和数量。分层与增强机制相结合，在目标群体中的敏感性达到86%，每年的误报率约为1.5次。警报系统基于规则运行，根据可解释的信号进行操作，可为患者或其护理人员提供对呼吸状况更好地洞察。基于咳嗽趋势运行的增强型警报系统有望提高在目标群体中检测AE-COPD的精准度。由于增强型系统的设计和测试基于相同的数据，该系统需要进行验证。警报系统中的信号可能有助于目标群体改善自我管理。
