Prevalence of information gaps in the emergency department and the effect on patient outcomes.
Notice bibliographique
Résumé
BACKGROUND: Information gaps occur when previously collected information is unavailable to a physician who is currently treating a patient. In this study we measured the prevalence of physician-reported information gaps for patients presenting to an emergency department at a teaching hospital. METHODS: For 1002 visits to the emergency department made by 983 patients, we recorded all information gaps identified by the emergency physician immediately after the patient was assessed. When an information gap was present, the physician was asked to identify the required information, why it was required and how important it was to the patient's care. We reviewed the patient charts to measure severity of illness and to determine whether the patient was referred to the emergency department by a community physician. Multiple linear regression analysis was used to determine whether information gaps were associated with length of stay in the emergency department. RESULTS: At least 1 information gap was identified in 323 (32.2%) of the 1002 visits (95% confidence interval 29.4%-35.2%). Information gaps were associated with severity of illness, being significantly more common in patients who had serious chronic illnesses, those who arrived by ambulance, those who had visited the emergency department or had been in hospital recently, patients in monitored areas in the emergency department and older patients. Information gaps most commonly comprised medical history (58%) and laboratory test results (23.3%) and were felt to be essential to patient care in 47.8% of the cases. The presence of information gaps was not associated with admission to hospital. After adjusting for important confounders, including patient sex, previous hospital admissions, diagnosis and severity of illness, we found that stays in the emergency department were 1.2 hours longer on average for patients with an information gap than for those without one. INTERPRETATION: Information gaps were present in almost one-third of the visits to our emergency department. They were more common in sicker patients and were independently associated with a prolonged stay in the emergency department.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,007 | 0,075 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».