Clinical Decision Support System to Enhance Quality Control of Spirometry Using Information and Communication Technologies
Identifieur interne : 000B12 ( Ncbi/Checkpoint ); précédent : 000B11; suivant : 000B13Clinical Decision Support System to Enhance Quality Control of Spirometry Using Information and Communication Technologies
Auteurs :Source :
- JMIR Medical Informatics [ 2291-9694 ] ; 2014.
Abstract
We recently demonstrated that quality of spirometry in primary care could markedly improve with remote offline support from specialized professionals. It is hypothesized that implementation of automatic online assessment of quality of spirometry using information and communication technologies may significantly enhance the potential for extensive deployment of a high quality spirometry program in integrated care settings.
The objective of the study was to elaborate and validate a Clinical Decision Support System (CDSS) for automatic online quality assessment of spirometry.
The CDSS was done through a three step process including: (1) identification of optimal sampling frequency; (2) iterations to build-up an initial version using the 24 standard spirometry curves recommended by the American Thoracic Society; and (3) iterations to refine the CDSS using 270 curves from 90 patients. In each of these steps the results were checked against one expert. Finally, 778 spirometry curves from 291 patients were analyzed for validation purposes.
The CDSS generated appropriate online classification and certification in 685/778 (88.1%) of spirometry testing, with 96% sensitivity and 95% specificity.
Consequently, only 93/778 (11.9%) of spirometry testing required offline remote classification by an expert, indicating a potential positive role of the CDSS in the deployment of a high quality spirometry program in an integrated care setting.
Url:
DOI: 10.2196/medinform.3179
PubMed: 25600957
PubMed Central: 4288080
Affiliations:
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PMC:4288080Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Clinical Decision Support System to Enhance Quality Control of Spirometry Using Information and Communication Technologies</title></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25600957</idno><idno type="pmc">4288080</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4288080</idno><idno type="RBID">PMC:4288080</idno><idno type="doi">10.2196/medinform.3179</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">000497</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000497</idno><idno type="wicri:Area/Pmc/Curation">000497</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000497</idno><idno type="wicri:Area/Pmc/Checkpoint">000184</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000184</idno><idno type="wicri:Area/Ncbi/Merge">000B12</idno><idno type="wicri:Area/Ncbi/Curation">000B12</idno><idno type="wicri:Area/Ncbi/Checkpoint">000B12</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Clinical Decision Support System to Enhance Quality Control of Spirometry Using Information and Communication Technologies</title></analytic><series><title level="j">JMIR Medical Informatics</title><idno type="eISSN">2291-9694</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec sec-type="Background"><title>Background</title><p>We recently demonstrated that quality of spirometry in primary care could markedly improve with remote offline support from specialized professionals. It is hypothesized that implementation of automatic online assessment of quality of spirometry using information and communication technologies may significantly enhance the potential for extensive deployment of a high quality spirometry program in integrated care settings.</p></sec><sec sec-type="Objective"><title>Objective</title><p>The objective of the study was to elaborate and validate a Clinical Decision Support System (CDSS) for automatic online quality assessment of spirometry.</p></sec><sec sec-type="Methods"><title>Methods</title><p>The CDSS was done through a three step process including: (1) identification of optimal sampling frequency; (2) iterations to build-up an initial version using the 24 standard spirometry curves recommended by the American Thoracic Society; and (3) iterations to refine the CDSS using 270 curves from 90 patients. In each of these steps the results were checked against one expert. Finally, 778 spirometry curves from 291 patients were analyzed for validation purposes.</p></sec><sec sec-type="Results"><title>Results</title><p>The CDSS generated appropriate online classification and certification in 685/778 (88.1%) of spirometry testing, with 96% sensitivity and 95% specificity.</p></sec><sec sec-type="Conclusions"><title>Conclusions</title><p>Consequently, only 93/778 (11.9%) of spirometry testing required offline remote classification by an expert, indicating a potential positive role of the CDSS in the deployment of a high quality spirometry program in an integrated care setting.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Celli, Br" uniqKey="Celli B">BR Celli</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Burgos, F" uniqKey="Burgos F">F Burgos</name></author><author><name sortKey="Disdier, C" uniqKey="Disdier C">C Disdier</name></author><author><name 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Burgos</name></author><author><name sortKey="Casaburi, R" uniqKey="Casaburi R">R Casaburi</name></author><author><name sortKey="Coates, A" uniqKey="Coates A">A Coates</name></author><author><name sortKey="Van Der Grinten, Cp" uniqKey="Van Der Grinten C">Cp van der Grinten</name></author><author><name sortKey="Gustafsson, P" uniqKey="Gustafsson P">P Gustafsson</name></author><author><name sortKey="Hankinson, J" uniqKey="Hankinson J">J Hankinson</name></author><author><name sortKey="Jensen, R" uniqKey="Jensen R">R Jensen</name></author><author><name sortKey="Johnson, Dc" uniqKey="Johnson D">Dc Johnson</name></author><author><name sortKey="Macintyre, N" uniqKey="Macintyre N">N Macintyre</name></author><author><name sortKey="Mckay, R" uniqKey="Mckay R">R McKay</name></author><author><name sortKey="Miller, Mr" uniqKey="Miller M">Mr Miller</name></author><author><name sortKey="Navajas, D" uniqKey="Navajas D">D Navajas</name></author><author><name sortKey="Pedersen, Of" uniqKey="Pedersen 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