Home Monitoring Delivered Through the Emergency Department for Outpatients With COVID-19: COVID19@Home Aachen Pilot Cohort Study
Notice bibliographique
Résumé
Background: The overwhelming COVID-19 situation in 2020/2021 required novel approaches that did not require additional personnel within the current health care system. Therefore, we initiated a trial of nonsupervised home monitoring via the emergency department of a tertiary hospital without the support of a virtual ward as part of the "Netzwerk Universitaetsmedizin" cooperation in Germany. Given that daily vital sign checks for inpatients with COVID-19 could indicate clinical deterioration, this approach might also be helpful in an outpatient setting and could help to identify the need for hospitalization and additional resources. Objective: This study aims to determine whether patient-led home monitoring for acute SARS-CoV-2 infection can be implemented through the emergency department of a tertiary care provider. Methods: Patients who tested positive for SARS-CoV-2 infection in our emergency department between May 2021 and May 2022, did not have a medical indication for hospitalization, and were discharged to the outpatient setting were offered the opportunity to perform nonsupervised home monitoring of vital signs. Those who agreed to participate received Bluetooth-enabled devices to measure temperature, oxygen saturation, and blood pressure and downloaded a smartphone app. Participants were encouraged to measure their vital signs for at least 28 days. There was no virtual ward or real-time surveillance of the recorded data, but these could be made available to primary care physicians. Compliance with self-measurements was determined, and participants were contacted after the monitoring period for a semistructured interview. Results: A total of 828 patients with COVID-19 were treated at the emergency department. Of these, 262 were directly discharged into ambulatory isolation after initial assessment, 25 were offered the opportunity of nonsupervised home monitoring, 15 successfully activated the devices, and 9 performed more than one complete measurement using the app. These 9 participants used the devices for an average of 15.8 days after discharge. Interviewed participants reported various difficulties with device setup but said they were pleased to use home monitoring and felt that the measurement option gave them additional security. Conclusions: This study highlighted the challenges associated with implementing nonsupervised home monitoring for outpatients with COVID-19 who presented to the emergency department of a tertiary hospital. Implementing such a system without the involvement of additional personnel does not appear to be the optimal approach. We suggest that the physician-patient relationship might be a factor that is essential for the success of patient-led approaches to home monitoring.
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 | 0,002 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,001 |
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 ».