Diagnosis最新文献_第7页

The growing threat of hijacked journals. 期刊被劫持的威胁日益严重。

IF 2.2

Diagnosis Pub Date : 2024-06-27 eCollection Date: 2024-08-01 DOI: 10.1515/dx-2024-0103

Mark L Graber, Mario Plebani

引用次数: 0

Delayed diagnosis of new onset pediatric diabetes leading to diabetic ketoacidosis: a retrospective cohort study. 导致糖尿病酮症酸中毒的新发儿童糖尿病延迟诊断：一项回顾性队列研究。

IF 2.2

Diagnosis Pub Date : 2024-06-27 eCollection Date: 2024-11-01 DOI: 10.1515/dx-2024-0024

Stephanie M Hadley, Kenneth A Michelson

{"title":"Delayed diagnosis of new onset pediatric diabetes leading to diabetic ketoacidosis: a retrospective cohort study.","authors":"Stephanie M Hadley, Kenneth A Michelson","doi":"10.1515/dx-2024-0024","DOIUrl":"10.1515/dx-2024-0024","url":null,"abstract":"Objectives: Patients with a delayed diagnosis of diabetes are more likely to present in diabetic ketoacidosis (DKA). The objective of this study was to assess the prevalence, risk factors, and consequences of missed pediatric diabetes diagnoses in emergency departments (EDs) potentially leading to DKA.Methods: Cases of children under 19 years old with a first-time diagnosis of diabetes mellitus presenting to EDs in DKA were drawn from the Healthcare Cost and Utilization Project database. A total of 11,716 cases were included. A delayed diagnosis of diabetes leading to DKA was defined by an ED discharge in the 14 days prior to the DKA diagnosis. The delayed diagnosis cases were analyzed using multivariate analysis to identify risk factors associated with delay, with the primary exposure being child opportunity index (COI) and secondary exposure being race/ethnicity. Rates of complications were compared across groups.Results: Delayed diagnosis of new onset diabetes leading to DKA occurred in 2.9 %. Delayed diagnosis was associated with COI, with 4.5 , 3.5, 1.9, and 1.5 % occurring by increasing COI quartile (p<0.001). Delays were also associated with younger age and non-Hispanic Black race. Patients with a delayed diagnosis were more likely to experience complications (4.4 vs. 2.2 %, p=0.01) including mechanical ventilation, as well as more frequent intensive care unit admissions and longer length of stays.Conclusions: Among children with new-onset DKA, 2.9 % had a delayed diagnosis. Delays were associated with complications. Children living in areas with lower child opportunity and non-Hispanic Black children were at higher risk of delays.","PeriodicalId":11273,"journal":{"name":"Diagnosis","volume":" ","pages":"416-421"},"PeriodicalIF":2.2,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141450064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

What is diagnostic safety? A review of safety science paradigms and rethinking paths to improving diagnosis. 什么是诊断安全？回顾安全科学范例，重新思考改进诊断的途径。

IF 2.2

Diagnosis Pub Date : 2024-05-27 eCollection Date: 2024-11-01 DOI: 10.1515/dx-2024-0008

Justin J Choi

引用次数: 0

Should APTT become part of thrombophilia screening? APTT 是否应成为血栓性疾病筛查的一部分？

IF 2.2

Diagnosis Pub Date : 2024-05-24 eCollection Date: 2024-11-01 DOI: 10.1515/dx-2024-0086

Giuseppe Lippi, Emmanuel J Favaloro

引用次数: 0

Recent mortality rates due to complications of medical and surgical care in the US. 美国医疗和外科护理并发症导致的最新死亡率。

IF 2.2

Diagnosis Pub Date : 2024-05-20 eCollection Date: 2024-11-01 DOI: 10.1515/dx-2024-0071

Camilla Mattiuzzi, Mario Plebani, Giuseppe Lippi

{"title":"Recent mortality rates due to complications of medical and surgical care in the US.","authors":"Camilla Mattiuzzi, Mario Plebani, Giuseppe Lippi","doi":"10.1515/dx-2024-0071","DOIUrl":"10.1515/dx-2024-0071","url":null,"abstract":"Objectives: Medical errors and complications pose a major threat to the safety of healthcare systems worldwide. This article was hence aimed at determining the current burden of complications of medical and surgical care in the US.Methods: We searched the latest version of the US Centers for Disease Control and Prevention (CDC) WONDER online database (years 2018-2022) using ICD-10 codes Y40-Y84 (complications of medical and surgical care).Results: The age-adjusted death rate for complications of medical and surgical care increased from 1.17 × 100,000 in 2018 to 1.49 × 100,000 in 2021, but then declined to 0.85 × 100,000 in 2022. The gender-specific analysis showed a similar trend, with the age-adjusted death rate values always being higher in men than in women. A clear age-dependent relationship was also found in the crude mortality rate for complications of medical and surgical care, as higher death rates were observed in older patients.Conclusions: This analysis reveals that the burden of complications of medical and surgical care has increased over time, especially during the COVID-19 pandemic, but has then considerably declined in 2022. However, root cause analysis and actions are still needed for preventing the still noticeable consequences of medical complications.","PeriodicalId":11273,"journal":{"name":"Diagnosis","volume":" ","pages":"443-445"},"PeriodicalIF":2.2,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140955507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Quality of heart failure registration in primary care: observations from 1 million electronic health records in the Amsterdam Metropolitan Area. 初级医疗中心力衰竭登记的质量：从阿姆斯特丹大都会区 100 万份电子健康记录中观察到的结果。

IF 2.2

Diagnosis Pub Date : 2024-05-14 eCollection Date: 2024-11-01 DOI: 10.1515/dx-2024-0009

Lukas De Clercq, Jelle C L Himmelreich, Ralf E Harskamp

{"title":"Quality of heart failure registration in primary care: observations from 1 million electronic health records in the Amsterdam Metropolitan Area.","authors":"Lukas De Clercq, Jelle C L Himmelreich, Ralf E Harskamp","doi":"10.1515/dx-2024-0009","DOIUrl":"10.1515/dx-2024-0009","url":null,"abstract":"Objectives: Proper coding of heart failure (HF) in electronic health records (EHRs) is an important prerequisite for adequate care and research towards this vulnerable patient population. We set out to evaluate the accuracy of registration of HF diagnoses in primary care EHRs.Methods: In a routine primary care database covering the Amsterdam Metropolitan Area, we identified all episodes of care with International Classification of Primary Care (ICPC) codes K77 (decompensatio cordis) or K84.03 (cardiomyopathy) up to 31/12/2021. We also performed two text-based searches to identify HF episodes without an appropriate ICPC-code. An expert panel evaluated all ICPC and text matches for congruence between the assigned codes and notes.Results: From a database of 968,433 records we identified 19,106 patients (2.0 %) with a total of 24,011 ICPC-coded HF episodes. Removal of 1,324 episodes found to concern other or uncertain diagnoses and inclusion of 4,582 validated HF episodes identified through text search led to exclusion of 909 (overregistration: 4.8 %) and inclusion of 2,266 additional patients (underregistration: 11.1 %). The inclusion of miscoded HF episodes advanced the first known date of HF diagnosis in 3.9 % of records, with a median shift of 3.45 years. Episode-level underregistration decreased significantly over time, from 23.8 % in 2006 to 10.0 % in 2021.Conclusions: While there is improvement over time, there are still substantial levels of over- and underregistration of HF, emphasizing the need for cautious interpretation of ICPC-coded data. The findings contribute to the understanding of HF registration issues in primary care and provide insights for improving registration practices.","PeriodicalId":11273,"journal":{"name":"Diagnosis","volume":" ","pages":"380-388"},"PeriodicalIF":2.2,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140916190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unclassified green dots on nucleated red blood cells (nRBC) plot in DxH900 from a patient with hyperviscosity syndrome. 一位高粘度综合征患者的 DxH900 中有核红细胞（nRBC）图上的未分类绿点。

IF 2.2

Diagnosis Pub Date : 2024-05-10 eCollection Date: 2025-02-01 DOI: 10.1515/dx-2024-0038

Rafael José García Martínez, José Carlos Garrido Gomez, Enrique María Ocio San Miguel, María Josefa Muruzábal Sitges

引用次数: 0

n-3 fatty acids and the risk of atrial fibrillation, review. n-3 脂肪酸与心房颤动风险，综述。

IF 2.2

Diagnosis Pub Date : 2024-05-09 eCollection Date: 2024-11-01 DOI: 10.1515/dx-2024-0077

Wolfgang Herrmann, Markus Herrmann

{"title":"n-3 fatty acids and the risk of atrial fibrillation, review.","authors":"Wolfgang Herrmann, Markus Herrmann","doi":"10.1515/dx-2024-0077","DOIUrl":"10.1515/dx-2024-0077","url":null,"abstract":"Atrial fibrillation (AF) is the most frequent type of cardiac arrhythmia that affects over six million individuals in Europe. The incidence and prevalence of AF rises with age, and often occurs after cardiac surgery. Other risk factors correlated with AF comprise high blood pressure, diabetes mellitus, left atrial enlargement, ischemic heart disease, and congestive heart failure. Considering the high prevalence of AF in aging societies, strategies to prevent serious complications, such as stroke or heart failure, are important because they are correlated with high morbidity and mortality. The supplementation of sea-derived n-3 polyunsaturated fatty acids (PUFA) is widely discussed in this context, but the results of experimental and observational studies are in contrast to randomized placebo-controlled intervention trials (RCTs). Specifically, larger placebo-controlled n-3 PUFA supplementation studies with long follow-up showed a dose-dependent rise in incident AF. Daily n-3 PUFA doses of ≥1 g/d are correlated with a 50 % increase in AF risk, whereas a daily intake of <1 g/d causes AF in only 12 %. Individuals with a high cardiovascular risk (CVD) risk and high plasma-triglycerides seem particularly prone to develop AF upon n-3 PUFA supplementation. Therefore, we should exercise caution with n-3 PUFA supplementation especially in patients with higher age, CVD, hypertriglyceridemia or diabetes. In summary, existing data argue against the additive intake of n-3 PUFA for preventative purposes because of an incremental AF risk and lacking CVD benefits. However, more clinical studies are required to disentangle the discrepancy between n-3 PUFA RCTs and observational studies showing a lower CVD risk in individuals who regularly consume n-3 PUFA-rich fish.","PeriodicalId":11273,"journal":{"name":"Diagnosis","volume":" ","pages":"345-352"},"PeriodicalIF":2.2,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140876066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Computerized diagnostic decision support systems - a comparative performance study of Isabel Pro vs. ChatGPT4. 计算机诊断决策支持系统--伊莎贝尔专业版与 ChatGPT4 的性能比较研究。

IF 2.2

Diagnosis Pub Date : 2024-05-07 eCollection Date: 2024-08-01 DOI: 10.1515/dx-2024-0033

Joe M Bridges

{"title":"Computerized diagnostic decision support systems - a comparative performance study of Isabel Pro vs. ChatGPT4.","authors":"Joe M Bridges","doi":"10.1515/dx-2024-0033","DOIUrl":"10.1515/dx-2024-0033","url":null,"abstract":"Objectives: Validate the diagnostic accuracy of the Artificial Intelligence Large Language Model ChatGPT4 by comparing diagnosis lists produced by ChatGPT4 to Isabel Pro.Methods: This study used 201 cases, comparing ChatGPT4 to Isabel Pro. Systems inputs were identical. Mean Reciprocal Rank (MRR) compares the correct diagnosis's rank between systems. Isabel Pro ranks by the frequency with which the symptoms appear in the reference dataset. The mechanism ChatGPT4 uses to rank the diagnoses is unknown. A Wilcoxon Signed Rank Sum test failed to reject the null hypothesis.Results: Both systems produced comprehensive differential diagnosis lists. Isabel Pro's list appears immediately upon submission, while ChatGPT4 takes several minutes. Isabel Pro produced 175 (87.1 %) correct diagnoses and ChatGPT4 165 (82.1 %). The MRR for ChatGPT4 was 0.428 (rank 2.31), and Isabel Pro was 0.389 (rank 2.57), an average rank of three for each. ChatGPT4 outperformed on Recall at Rank 1, 5, and 10, with Isabel Pro outperforming at 20, 30, and 40. The Wilcoxon Signed Rank Sum Test confirmed that the sample size was inadequate to conclude that the systems are equivalent. ChatGPT4 fabricated citations and DOIs, producing 145 correct references (87.9 %) but only 52 correct DOIs (31.5 %).Conclusions: This study validates the promise of Clinical Diagnostic Decision Support Systems, including the Large Language Model form of artificial intelligence (AI). Until the issue of hallucination of references and, perhaps diagnoses, is resolved in favor of absolute accuracy, clinicians will make cautious use of Large Language Model systems in diagnosis, if at all.","PeriodicalId":11273,"journal":{"name":"Diagnosis","volume":" ","pages":"250-258"},"PeriodicalIF":2.2,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140848080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Computable phenotype for diagnostic error: developing the data schema for application of symptom-disease pair analysis of diagnostic error (SPADE). 诊断错误的可计算表型：为诊断错误的症状-疾病配对分析 (SPADE) 应用开发数据模式。

IF 2.2

Diagnosis Pub Date : 2024-05-03 eCollection Date: 2024-08-01 DOI: 10.1515/dx-2023-0138

Ahmed Hassoon, Charles Ng, Harold Lehmann, Hetal Rupani, Susan Peterson, Michael A Horberg, Ava L Liberman, Adam L Sharp, Michelle C Johansen, Kathy McDonald, J Mathrew Austin, David E Newman-Toker

{"title":"Computable phenotype for diagnostic error: developing the data schema for application of symptom-disease pair analysis of diagnostic error (SPADE).","authors":"Ahmed Hassoon, Charles Ng, Harold Lehmann, Hetal Rupani, Susan Peterson, Michael A Horberg, Ava L Liberman, Adam L Sharp, Michelle C Johansen, Kathy McDonald, J Mathrew Austin, David E Newman-Toker","doi":"10.1515/dx-2023-0138","DOIUrl":"10.1515/dx-2023-0138","url":null,"abstract":"Objectives: Diagnostic errors are the leading cause of preventable harm in clinical practice. Implementable tools to quantify and target this problem are needed. To address this gap, we aimed to generalize the Symptom-Disease Pair Analysis of Diagnostic Error (SPADE) framework by developing its computable phenotype and then demonstrated how that schema could be applied in multiple clinical contexts.Methods: We created an information model for the SPADE processes, then mapped data fields from electronic health records (EHR) and claims data in use to that model to create the SPADE information model (intention) and the SPADE computable phenotype (extension). Later we validated the computable phenotype and tested it in four case studies in three different health systems to demonstrate its utility.Results: We mapped and tested the SPADE computable phenotype in three different sites using four different case studies. We showed that data fields to compute an SPADE base measure are fully available in the EHR Data Warehouse for extraction and can operationalize the SPADE framework from provider and/or insurer perspective, and they could be implemented on numerous health systems for future work in monitor misdiagnosis-related harms.Conclusions: Data for the SPADE base measure is readily available in EHR and administrative claims. The method of data extraction is potentially universally applicable, and the data extracted is conveniently available within a network system. Further study is needed to validate the computable phenotype across different settings with different data infrastructures.","PeriodicalId":11273,"journal":{"name":"Diagnosis","volume":" ","pages":"295-302"},"PeriodicalIF":2.2,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11392038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140848588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0