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Abstract

Objectives . The aim of this study was to examine risk factors that predict persistent healthcare frequent attendance among a frequent attender (FA) population. Design. Prospective cohort study without intervention. Setting. Primary healthcare centre in Tampere, Finland. Subjects. A total of 85 primary healthcare working-age patients participated in the study. All participants were FAs in the first study year. Main outcome measures. We identified two groups of patients: temporary FAs and persistent FAs. A patient was considered as a persistent FA if he or she visited the health centre at least eight times a year for at least three out of four follow-up years. Some 59 different variables were examined as potential risk factors for persistent FA. P-course, a web-based Na ï ve Bayesian classification tool, was used for the modelling of the data. Results. In our model, the most influential predictive risk factors for persistent frequent attendance in an FA population were female gender, body mass index above 30, former frequent attendance, fear of death, alcohol abstinence, low patient satisfaction, and irritable bowel syndrome. New observations were high body mass index, alcohol abstinence, irritable bowel syndrome, low patient satisfaction, and fear of death. Conclusions. In FA analyses, distinction between temporary and persistent frequent attendance should be made. Our Bayesian model could be used for identifying persistent FAs in uncertain situations. The model can quite easily be further developed as a practical decision support tool for general practitioners. However, before its use in practice, the external validity of the model will need to be defined.  相似文献   
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Objective - To try out a collection of a standard set of data from computerised medical records. Design - Retrospective extraction of ordinary patient record information put into the computer by general practitioners. Setting - Encounters in office hours in strategically selected practices or health centres in Denmark, Finland, Iceland, Norway and Sweden. Subjects - 59 general practitioners and a total study population of 97475 persons. Main outcome measures - Proportions, crude and specific rates of encounters, diagnoses and processes. Results - In a 4-week period there was a threefold difference in the office encounter rates between the participating sites in the Nordic countries. Gender and age patterns were similar despite these differ ences. An access to several different denominators revealed diverse patterns of referring to the specialist, prescribing, ordering blood tests, X-rays and physiotherapy. Data from computerised medical records agree well with earlier studies in the Nordic countries using other methods. Conclusions - This survey demonstrates that valid and reliable data for routine statistics are available from computerised medical records in general practice. The major obstacle extracting more epidemiological data from computerised medical records is caused by information in the databases not being uniquely linked to episodes of care.  相似文献   
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The scientific community is charged with growing demands regarding the management of project data and outputs and the dissemination of key results to various stakeholders. We discuss experiences and lessons from CONTRAST, a multidisciplinary alliance that had been funded by the European Commission over a 4-year period, in order to optimize schistosomiasis control and transmission surveillance in sub-Saharan Africa. From the start, project partners from Europe and Africa set out an ambitious goal: to sample data following standard protocols at all field sites and then sharing the data in a way that would enable all project partners to have access through a password-protected Internet-based data portal. This required anonymous agreement on several common standardized sample forms, ranging from the mundane but important issue of using the same units of measurement to more complex challenges, for instance agreeing on the same protocols for double-treatment of praziquantel in different settings. With the experiences gained by the CONTRAST project, this paper discusses issues of data management and sharing in research projects in the light of the current donor demand, and offers advice and specific suggestions for similar interdisciplinary research projects.  相似文献   
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简要介绍军队医院开展学科化服务的内涵,对相关调查表进行设计,提出围绕军队医院临床医疗、教学、科研及重大课题开展学科化服务的具体内容,结合中国人民解放军空军总医院实践阐述开展学科化服务的具体做法及今后的发展方向。  相似文献   
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以湖南省儿童医院为例,介绍医院移动业务平台中安全模式设计及应用,包括整体架构、安全接入设备实施方案、安全认证模式策略几方面,为安全部署远程办公、移动应用提供实施思路。  相似文献   
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针对医学数字资源构建长期保存标准体系,结合研究现状,设计体系框架,为具有长期保存价值的医学数字资源提供保存标准,以期指导后续保存系统应用实践。  相似文献   
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以中医药院校图书馆为例,阐述特色资源内涵,运用SWOT分析法分析“双一流”背景下医学高校图书馆特色资源建设的优势、劣势、机遇和挑战,提出相应建议,包括提升采访馆员素质、制定特色馆藏标准等。  相似文献   
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《中国现代医生》2020,58(4):136-138
目的 探讨数据系统分类标准(BI-RADS)联合超微血管成像(SMI)技术在乳腺实性结节鉴别诊断中的应用效果。方法 回顾性分析2018 年7 月~2019 年8 月收治的94 例乳腺结节患者临床资料。所有患者均行常规超声和SMI 检查,根据二维超声结果予以BI-RADS 分类,并经手术或穿刺病理活检。评估BI-RADS 分类、SMI 技术单独及联合诊断乳腺实性结节的诊断结果,计算诊断效能(准确度、敏感度、特异度、阳性及阴性预测值),绘制ROC曲线比较不同诊断方法效能。结果 ①SMI 诊断乳腺结节良恶性灵敏度、阴性预测值高于BI-RADS 分类,特异度、准确率、阳性预测值低于BI-RADS 分类,联合检测灵敏度、特异度、准确率、阳性预测值、阴性预测值均高于BI-RADS 分类及SMI 单独诊断;②联合检查诊断曲线下面积(AUC)高于BI-RADS 分类和SMI,SMI 诊断AUC 高于BI-RADS 分类(P<0.05)。结论BI-RADS 分类联合SMI 技术在乳腺实性结节鉴别诊断中效能较高,临床应用前景可观。  相似文献   
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