Decision Support for Evaluation of the Febrile Infant

发热婴儿评估的决策支持

• 批准号: 7052833
• 负责人: Carrie L. Byington
• 金额: $ 12.05万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-04-15 至 2010-03-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7052833
• 关键词: antibiotics; bacterial disease; behavioral /social science research tag; clinical research; computer assisted diagnosis; computer assisted medical decision making; diagnosis design /evaluation; diagnosis quality /standard; health care service evaluation; health services research tag; hospital utilization; human data; hyperthermia; infant human (0-1 year); parents; patient oriented research; patient safety /medical error; pediatrics; satisfaction

DESCRIPTION (provided by applicant): The purpose of this K24 application is to support the patient-oriented research performed by Carrie Byington, MD and to provide her with career development opportunities that will enhance her ability to mentor young clinical investigators, especially women and minorities. The research application focuses on the application of computerized decision support to the management of the febrile infant 1-90 days of age. The evaluation and management of fever accounts for 20% of medical encounters in this age group. There is significant variation in the management of febrile infants and this variation has serious implications for patient safety and health care cost. In the last decade, research data has been generated that could be translated into improved quality of care for febrile infants in the US. Using data I have collected and analyzed over the last 9 years, I have developed a method for the management of the febrile infant, that incorporates viral diagnostic testing, that I believe will improve care and patient safety by providing physicians with information needed to calculate an individual infant's risk of bacterial infection. This algorithm exists as a computerized Bayesian model that must be tested prospectively. I hypothesize that 1) There is significant and inappropriate variation among Intermountain Health Care (IHC) physicians in the diagnosis and management of febrile infants, 2) variation will be reduced by the use of a decision support module that is based on a software program that integrates new data and diagnostic methods, and 3) The use of the module will result in a 50% reduction in length of stay and in duration of antibiotic treatment for febrile infants with no increase in missed cases of serious bacterial infection. The Specific Aims of this project are: 1) Determine baseline practices regarding the evaluation and management of febrile infants at three IHC facilities (Primary Children's, Utah Valley, and McKay Dee Medical Centers) from 2000-2004 by analyzing data from the computerized IHC Data warehouse, 2) Implement, during a 24-month period, the decision support tool at the same three hospitals, 3) Compare data obtained before and after computerized decision support was available to determine whether improvements in patient care and safety can be documented. This project can provide data that will improve the care of the febrile infant regionally and can inform future national studies.

描述（由申请人提供）：该K24申请的目的是支持医学博士Carrie Byington进行的以患者为导向的研究，并为她提供职业发展机会，以增强她指导年轻临床研究人员，尤其是妇女和少数群体的能力。研究申请的重点是将计算机决策支持应用于1-90天大的高温婴儿的管理。在这个年龄段的人群中，发烧的评估和管理占医疗遭遇的20％。高热婴儿的管理有很大的差异，这种差异对患者的安全和医疗保健成本具有严重影响。在过去的十年中，已经生成了研究数据，可以将其转化为美国热潮婴儿的护理质量。使用我在过去9年中收集和分析的数据，我开发了一种用于管理高温婴儿的方法，该方法结合了病毒诊断测试，我相信，我相信，通过为医生提供计算单个婴儿细菌感染风险所需的信息，这将改善护理和患者的安全。该算法作为计算机化的贝叶斯模型存在，必须预先测试。我假设1）在诊断和管理中，山间医疗保健（IHC）医生之间存在显着且不当变化遗失严重细菌感染病例的婴儿没有增加。该项目的具体目的是：1）从2000年至2004年开始三个IHC设施（主要儿童，犹他州谷和麦凯·迪医学中心）评估和管理的基线实践，分析计算机化IHC数据仓库的计算机化数据，并在24个月的Disciputition Deciption and Intimans Intimans Intimans Intimans Procipation Intimane Comprized Intimants，然后在3个临时数据中进行分析，并在三个月内进行了分析，并在3次临时数据进行了审查。确定是否可以记录患者护理和安全方面的改善。该项目可以提供可以改善当地热火婴儿的护理的数据，并可以为未来的国家研究提供信息。