Knapp M S, Smith A F, Trimble I M, Pownall R, Gordon K
Kidney Int. 1983 Oct;24(4):474-86. doi: 10.1038/ki.1983.184.
The monitoring of renal patients and the making of many decisions during their management involves consideration of sequences of numerical data. Renal function results after renal transplantation were used as an example of how graphical presentations, simple mathematical transforms, statistical evaluation and adjustments to the data, to take into account other biological and technical sources of error, can all contribute to better understanding. Experience with a statistical technique, the 4-state Kalman filter not often used in the biological sciences, was summarized and its use suggested as a method to quantitate some traditionally subjective decisions about individual patients, for example, the onset of allograft rejection. The method has identified in retrospect and in prospect events after transplantation earlier than did experienced clinicians. Other statistical techniques to set the sensitivity and specificity of monitoring methods, to detect change points and to quantitate rhythmic sequences of clinical data were discussed, with examples, and with increasing access to computers, these can be used more easily by nephrologists, transplant surgeons, and others.
对肾病患者的监测以及在其治疗过程中做出的许多决策都涉及对一系列数值数据的考量。以肾移植后的肾功能结果为例，说明图形展示、简单的数学变换、统计评估以及对数据的调整（以考虑其他生物学和技术误差来源）如何都有助于更好地理解。总结了一种统计技术——四状态卡尔曼滤波器（在生物科学中不常使用）的经验，并建议将其作为一种方法来量化一些关于个体患者的传统主观决策，例如同种异体移植排斥反应的发生。该方法在回顾和前瞻性研究中比经验丰富的临床医生更早地识别出移植后的事件。还讨论了其他统计技术，用于设定监测方法的敏感性和特异性、检测变化点以及量化临床数据的节律序列，并举例说明。随着计算机的普及，肾病学家、移植外科医生和其他人可以更轻松地使用这些技术。
