Web-Based Patient Segmentation in Finnish Primary Care: Protocol for Clinical Validation of the Navigator Service in Patients With Diabetes
Notice bibliographique
Résumé
BACKGROUND: An aging population and increasing multimorbidity challenge health care systems worldwide. Patient segmentation aims to recognize groups of patients with similar needs, offer targeted services to these groups, and reduce the burden of health care. In this study, the unique Finnish innovation Navigator, a web-based service for patient segmentation, is presented. Both patients and health care professionals complete the electronic questionnaire concerning patients' coping in everyday life and health state. Thus, it considers the patient perspective on self-care. One of four customership-strategy (CS) groups (self-acting, community, cooperating, and network) is then proposed in response to the answers given. This resulting strategy helps both professionals to coordinate patient health care and patients to utilize appropriate health services. OBJECTIVE: This study aims to determine the feasibility, validity, and reliability of the Navigator service in the segmentation of patients with diabetes into four CS groups in a primary care setting. Patient characteristics concerning demographic status, chronic conditions, disabilities, health-related quality of life, and well-being in different CS groups will be described. We hypothesize that patients in the network group will be older, have more illnesses, chronic conditions or disabilities, and require more health care services than patients in the self-acting group. METHODS: In this mixed methods study, data collection was based on questionnaires (user experience of Navigator, demographic and health status, World Health Organization Disability Assessment Schedule 2.0, EuroQol 5D, Wellbeing Questionnaire 12, and the Diabetes Treatment Satisfaction Questionnaire) issued to 300 patients with diabetes and on user-experience questionnaires for and semistructured focus-group interviews with 12 nurses. Navigator-database reports and diabetes-care values (blood pressure, BMI, HbA1c, low-density lipoprotein, albumin-creatinine, smoking status) were collected. Qualitative and descriptive analyses were used to study the feasibility, content, concurrent, and face validity of Navigator. While criterion and concurrent validity were examined with correlations, reliability was examined by calculating Cohen kappa and Cronbach alpha. Construct validity is studied by performing exploratory-factor analysis on Navigator data reports and by hypothesis testing. The values, demographics, and health status of patients in different groups were described, and differences between groups were studied by comparing means. Linear regression analysis was performed to assess which variables affect CS group variation. RESULTS: Data collection was completed in September 2019, and the first feasibility results are expected by the end of 2020. Further results and publications are expected in 2021 and 2022. CONCLUSIONS: This is the first scientific study concerning Navigator's psychometric properties. The study will examine the segregation of patients with diabetes into four CS groups in a primary care setting and the differences between patients in groups. This study will assist in Navigator's further development as a patient segmentation method considering patients' perspectives on self-care. This study will not prove the effectiveness or efficacy of Navigator; therefore, it is essential to study these outcomes of separate care pathways. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/20570.
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 | 0,026 | 0,024 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,002 |
| Méta-épidémiologie (sens large) | 0,002 | 0,002 |
| Bibliométrie | 0,003 | 0,002 |
| Études des sciences et des technologies | 0,004 | 0,002 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,028 | 0,005 |
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 ».