Abstract:
BACKGROUND:We aim to validate the diagnostic performance of the first fully automatic, electronic heart failure (HF) identification algorithm and evaluate the implementation of an HF Dashboard system with 2 components: real-time identification of decompensated HF admissions and accurate characterization of disease characteristics and medical therapy. METHODS:We constructed an HF identification algorithm requiring 3 of 4 identifiers: B-type natriuretic peptide >400 pg/mL; admitting HF diagnosis; history of HF International Classification of Disease, Ninth Revision, diagnosis codes; and intravenous diuretic administration. We validated the diagnostic accuracy of the components individually (n = 366) and combined in the HF algorithm (n = 150) compared with a blinded provider panel in 2 separate cohorts. We built an HF Dashboard within the electronic medical record characterizing the disease and medical therapies of HF admissions identified by the HF algorithm. We evaluated the HF Dashboard's performance over 26 months of clinical use. RESULTS:Individually, the algorithm components displayed variable sensitivity and specificity, respectively: B-type natriuretic peptide >400 pg/mL (89% and 87%); diuretic (80% and 92%); and International Classification of Disease, Ninth Revision, code (56% and 95%). The HF algorithm achieved a high specificity (95%), positive predictive value (82%), and negative predictive value (85%) but achieved limited sensitivity (56%) secondary to missing provider-generated identification data. The HF Dashboard identified and characterized 3147 HF admissions over 26 months. CONCLUSIONS:Automated identification and characterization systems can be developed and used with a substantial degree of specificity for the diagnosis of decompensated HF, although sensitivity is limited by clinical data input.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Cox ZL,Lewis CM,Lai P,Lenihan DJdoi
10.1016/j.ahj.2016.10.001subject
Has Abstractpub_date
2017-01-01 00:00:00pages
40-48eissn
0002-8703issn
1097-6744pii
S0002-8703(16)30213-7journal_volume
183pub_type
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pub_type: 杂志文章,多中心研究
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doi:10.1016/j.ahj.2008.07.018
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doi:10.1053/hj.1999.v137.92052
更新日期:1999-02-01 00:00:00
abstract::This prospective study evaluated the accuracy of phase analysis of scintigraphic imaging in defining the site of earliest ventricular activation in pediatric patients with electrophysiologic disorders. Twenty patients (10.8 +/- 5.5 years) with preexcitation (n = 16) or ventricular tachycardia (VT) (n = 4) were indepen...
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pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:2010-09-01 00:00:00
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更新日期:2013-01-01 00:00:00
abstract::The antiarrhythmic efficacy and safety of intravenous amiodarone were evaluated in 13 patients with recurrent sustained ventricular tachycardia. All patients had been refractory to at least three prior antiarrhythmic agents (mean, 3.3 per patient), and 11 had multiple direct current cardioversions. Intravenous amiodar...
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更新日期:2021-01-25 00:00:00
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更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:In patients hospitalized with acutely decompensated heart failure, unresolved signs and symptoms of fluid overload have been consistently associated with poor outcomes. Regardless of dosing and type of administration, intravenous loop diuretics have not reduced heart failure events or mortality in patients w...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2015-09-01 00:00:00
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更新日期:2004-05-01 00:00:00