A103 GUTLINK SMARTPATH: AN ONLINE TOOL TO IMPROVE PATIENT CARE
Notice bibliographique
Résumé
Abstract Background Lower gastrointestinal (GI) symptoms are common reasons patients present to primary healthcare providers (PHCP). It can be challenging for PHCPs to identify dietary and functional conditions versus serious illnesses that require specialty assessment. Unfortunately, access to GI care in Nova Scotia is limited with patients waiting well beyond published standards. The Division of Digestive Care and Endoscopy (DDCE) at Dalhousie University has developed a referral management system to prioritize patients. Unfortunately, the lack of standardization in referral requirements creates challenges to implementing a robust and accurate referral management system. To support the evaluation and management of patients with lower GI symptoms within primary care, we developed an adaptive clinical care pathway (SmartPath), delivered within an online platform, Virtual Hallway (VH). The SmartPath is an evidence-informed clinical support tool facilitating appropriate primary care investigations and management as well as specialist referrals, as required. Aims To evaluate the implementation and early effectiveness of the lower GI symptom SmartPath. Methods We conducted a cohort study of SmarthPaths initiated with primary care. Descriptive data was extracted from the Virtual Hallway platform, with results of a short survey PHCPs were asked to complete following completion of a SmartPath. To assess the quality of referrals facilited by SmartPath versus traditional referral pathways, a series of 20 consecutive referrals for 3 common lower GI complaints (diarrhea, constipation and rectal bleeding) were selected for comparison. Interim data is presented for Smartpaths initiated between October 2023 and August 2024. Results A total of 272 SmartPaths were initiated by 103 unique PCHPs, of which 179 (65.8%) led to a specific action, with the 93 (34.2%) remaining in process within primary care. Of the 37 DDCE referrals, 26 (62.1%) were accepted, 11 (29.7%) were declined or redirected to another service. 60 consecutive traditional lower GI symptoms referrals were analyzed, 27 (45%) of which were declined. 31 (51.7%) did not provide any investigations, 42 (70%) did not provide physical examinations, and 34 (56.7%) did not provide a past medical history. Survey responses were provided by 57 PHCPs with mean scores (out of 5) of 4.2 for ease of use, 3.9 for overall satisfaction, and 4.2 for likelihood to use again. Conclusions An adaptive care pathway is effective for facilitaing investigation and management of common lower GI symptoms within primary care while facilitating access to specialized services, as required. Referrals received through smartpath had a higher acceptance rate. Funding Agencies None
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 | 0,005 | 0,018 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,003 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,002 |
| Science ouverte | 0,001 | 0,003 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,061 | 0,008 |
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 ».