Customized reference ranges for laboratory values decrease false positive alerts in intensive care unit patients
| العنوان: | Customized reference ranges for laboratory values decrease false positive alerts in intensive care unit patients |
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| المؤلفون: | Juan N. Pulido, Vitaly Herasevich, Adil Ahmed, Kianoush Kashani, Ognjen Gajic, Oguz Kilickaya, Brian W. Pickering, Christopher N. Schmickl, James A. Onigkeit |
| المصدر: | PLoS ONE, Vol 9, Iss 9, p e107930 (2014) PLoS ONE |
| بيانات النشر: | Public Library of Science (PLoS), 2014. |
| سنة النشر: | 2014 |
| مصطلحات موضوعية: | Male, Pediatrics, Critical Care and Emergency Medicine, Medical Doctors, Health Care Providers, Problem list, lcsh:Medicine, Pathology and Laboratory Medicine, law.invention, law, Reference Values, Positive predicative value, Medicine and Health Sciences, Electronic Health Records, Hospital Mortality, lcsh:Science, Aged, 80 and over, Serodiagnosis, Multidisciplinary, Information Architecture, Middle Aged, Laboratory results, Intensive care unit, 3. Good health, Intensive Care Units, Serology, Female, Information Technology, Research Article, medicine.medical_specialty, Computer and Information Sciences, Critical Care, Critical Illness, Clinical Chemistry Tests, Methods laboratory, Sensitivity and Specificity, Diagnostic Medicine, Physicians, medicine, Humans, False Positive Reactions, Aged, business.industry, lcsh:R, Gold standard (test), Population Decrease, Health Care, Data Reduction, Emergency medicine, lcsh:Q, business, Kappa |
| الوصف: | Background Traditional electronic medical record (EMR) interfaces mark laboratory tests as abnormal based on standard reference ranges derived from healthy, middle-aged adults. This yields many false positive alerts with subsequent alert-fatigue when applied to complex populations like hospitalized, critically ill patients. Novel EMR interfaces using adjusted reference ranges customized for specific patient populations may ameliorate this problem. Objective To compare accuracy of abnormal laboratory value indicators in a novel vs traditional EMR interface. Methods Laboratory data from intensive care unit (ICU) patients consecutively admitted during a two-day period were recorded. For each patient, available laboratory results and the problem list were sent to two mutually blinded critical care experts, who marked the values about which they would like to be alerted. All disagreements were resolved by an independent super-reviewer. Based on this gold standard, we calculated and compared the sensitivity, specificity, positive and negative predictive values (PPV, NPV) of customized vs traditional abnormal value indicators. Results Thirty seven patients with a total of 1341 laboratory results were included. Experts’ agreement was fair (kappa = 0.39). Compared to the traditional EMR, custom abnormal laboratory value indicators had similar sensitivity (77% vs 85%, P = 0.22) and NPV (97.1% vs 98.6%, P = 0.06) but higher specificity (79% vs 61%, P |
| اللغة: | English |
| تدمد: | 1932-6203 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ee504827a73923353ecfc69045c92870Test http://europepmc.org/articles/PMC4169437?pdf=renderTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....ee504827a73923353ecfc69045c92870 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19326203 |
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