@文章{信息:doi/10.2196/27284，作者=“Scheinker, David和Gu, Angela和Grossman, Joshua和Ward, Andrew和Ayerdi, Oseas和Miller, Daniel和Leverenz, Jeannine和Hood, Korey和Lee, Ming Yeh和Maahs, David M和Prahalad, Priya”，标题=“基于算法的1型糖尿病的个性化血糖管理:，期刊=“JMIR糖尿病”，年=“2022”，月=“6”，日=“6”，卷=“7”，数=“2”，页=“e27284”，关键词=“远程医疗”;糖尿病;人口健康;连续血糖监测仪;背景:连续血糖监测仪(cgm)的使用被美国糖尿病协会推荐为1型糖尿病(T1D)患者的护理标准。很少有硬件不可知的、开源的、全人群的工具可以促进临床医生(如医生和认证糖尿病教育者)使用CGM数据。目的:本研究旨在开发一种工具，通过电子医疗记录使用异步消息识别适合接触的患者，同时最大限度地减少由认证糖尿病教育者或医生使用该工具检查的患者数量。方法:我们使用共识指南来开发糖尿病卓越及时干预(TIDE)，这是一种开源的硬件未知工具，用于分析CGM数据，通过生成通用标志(例如，平均血糖[MG] >170 MG /dL)和个性化标志(例如，MG增加>10 MG /dL)来识别血糖控制恶化的患者。在儿科T1D诊所进行的一项为期7周的前瞻性研究中，我们测量了TIDE在确定适合接触的患者和复查患者数量方面的敏感性。 We simulated measures of the workload generated by TIDE, including the average number of time in range (TIR) flags per patient per review period, on a convenience sample of eight external data sets, 6 from clinical trials and 2 donated by research foundations. Results: Over the 7 weeks of evaluation, the clinical population increased from 56 to 64 patients. The mean sensitivity was 99{\%} (242/245; SD 2.5{\%}), and the mean reduction in the number of patients reviewed was 42.6{\%} (182/427; SD 10.9{\%}). The 8 external data sets contained 1365 patients with 30,017 weeks of data collected by 7 types of CGMs. The rates of generic and personalized TIR flags per patient per review period were, respectively, 0.15 and 0.12 in the data set with the lowest average MG (141 mg/dL) and 0.95 and 0.22 in the data set with the highest average MG (207 mg/dL). Conclusions: TIDE is an open-source hardware-agnostic tool for personalized analysis of CGM data at the clinical population scale. In a pediatric T1D clinic, TIDE identified 99{\%} of patients appropriate for contact using an asynchronous message through electronic medical records while reducing the number of patients reviewed by certified diabetes care and education specialists by 43{\%}. For each of the 8 external data sets, simulation of the use of TIDE produced fewer than 0.25 personalized TIR flags per patient per review period. The use of TIDE to support telemedicine-based T1D care may facilitate sensitive and efficient guideline-based population health management. ", issn="2371-4379", doi="10.2196/27284", url="https://diabetes.www.mybigtv.com/2022/2/e27284", url="https://doi.org/10.2196/27284", url="http://www.ncbi.nlm.nih.gov/pubmed/35666570" }