This thesis describes the development and evaluation of a computerized algorithm for detecting patients with acute asthma exacerbations who present to a pediatric emergency department (ED). A rule-based algorithm was designed to collect patient information from the computerized patient record at the time of ED triage. We confirmed the feasibility of this approach through a retrospective analysis. The algorithm was then implemented in the pediatric ED as a real-time asthma detection system. Its performance was evaluated prospectively during a two-month study period on over 3,500 ED patients, of which 342 had an asthma exacerbation. The system was able detect patients presenting with acute asthma with high accuracy. Sensitivity was 71.6%, specificity was 97.8%, positive predictive value was 77.0%, and negative predictive value was 97.1%.
This research could be applied to detect and automatically initiate guidelines for the management of asthma in eligible patients, and could serve as a model for detecting other conditions which are managed by standardized guidelines in the ED.
| Identifer | oai:union.ndltd.org:VANDERBILT/oai:VANDERBILTETD:etd-04032006-113734 |
| Date | 17 April 2006 |
| Creators | Sanders, David L |
| Contributors | Dominik Aronsky, Kevin B Johnson, Neal R Patel |
| Publisher | VANDERBILT |
| Source Sets | Vanderbilt University Theses |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.vanderbilt.edu/available/etd-04032006-113734/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to Vanderbilt University or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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