通过对新转诊病人的分类,提高风湿病门诊的效率。

IF 2.1 Q3 RHEUMATOLOGY
Rheumatology Advances in Practice Pub Date : 2025-04-18 eCollection Date: 2025-01-01 DOI:10.1093/rap/rkae155
Sander Dijkstra, Yaël A de Man, Aleida Braaksma, Maurits de Graaf, Hein J Bernelot Moens, Richard J Boucherie
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引用次数: 0

摘要

目的:诊断风湿病患者新转介他们的全科医生需要风湿病学家的评估和诊断测试。理想情况下,这些测试在患者第一次咨询风湿病学家之前进行,旨在快速诊断和减少就诊次数。我们回顾性地研究了首次就诊前的数字患者问卷是否可以减少咨询次数和加快诊断速度。方法:我们应用基于机器学习的二元分类算法对新转诊患者的问卷数据进行分类,以区分患者的诊断类别(炎症与非炎症)。之后,当所有归类为非炎症的患者在第一次就诊时计划进行特定的诊断测试时,我们量化了风湿病诊所的益处。结果:炎性与非炎性疾病的分类准确率为0.771,灵敏度(召回率)为0.809,精密度为0.833。当非炎症分类患者在首次会诊前接受血液检查时,每位患者平均避免了0.1次面对面会诊和0.26次远程会诊,其代价是44%的新转诊患者过度诊断。如果除血液检查外,首次会诊前还进行放射检查,则平均每名患者可避免0.21次面对面会诊和0.49次远程会诊,其代价是71%的新转诊患者过度诊断(例如,仅进行血液检查或血液检查和放射检查相结合)。结论:基于首次就诊前患者问卷的分类算法可以缩短风湿病门诊的患者旅程,从而提高效率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Improving efficiency of a rheumatology outpatient clinic through classification of newly referred patients.

Objectives: Diagnosing a rheumatological disease in patients newly referred by their general practitioner requires assessment by a rheumatologist and often diagnostic tests. Ideally, these tests are performed prior to the patient's first consultation with the rheumatologist, aiming for quick diagnosis and fewer visits. We retrospectively studied whether a pre-first visit digital patient questionnaire can lead to fewer consultations and faster diagnosis.

Methods: We applied machine learning-based binary classification algorithms to questionnaire data of newly referred patients to classify a patient's diagnostic class (inflammatory vs. non-inflammatory). Afterwards, we quantified the rheumatology clinic's benefit when all patients classified to be non-inflammatory are planned for specific diagnostic tests at their first visit.

Results: Classification for inflammatory vs. non-inflammatory disease could be done with accuracy of 0.771, sensitivity (recall) of 0.809 and precision of 0.833. When non-inflammatory classified patients receive a blood test before first consultation, on average 0.1 in-person consultations and 0.26 teleconsultations per patient are avoided at the cost of having overdiagnostics for 44% of all newly referred patients. If, in addition to a blood test, the first consultation is also preceded by a radiology examination, on average 0.21 in-person consultations and 0.49 teleconsultations per patient are avoided, at the cost of having overdiagnostics (e.g. only the blood test or the combination of the blood test and radiology examination) for 71% of all newly referred patients.

Conclusion: Classification algorithms based on pre-first visit patient questionnaires may shorten the patient journey in a rheumatology outpatient clinic and may therefore improve efficiency.

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来源期刊
Rheumatology Advances in Practice
Rheumatology Advances in Practice Medicine-Rheumatology
CiteScore
3.60
自引率
3.20%
发文量
197
审稿时长
11 weeks
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