JMIR出版物:临床医生治疗偏好中临床兴趣的识别模式卡塔尔世界杯8强波胆分析无假设数据科学方法对临床评价的处方离群值进行优先化%A MacKenna,Brian %A Curtis,Helen %A Hopcroft,Lisa E M %A Walker,Alex J %A Croker,Richard %A Macdonald,Orla %A Evans,Stephen J W %A Inglesby,Peter %A Evans,David %A Morley,Jessica %A Bacon,Sebastian C J %A Goldacre,Ben + Bennett应用数据科学研究所,牛津大学纳菲尔德初级保健健康科学系,拉德克利夫初级保健大楼,雷德克里夫天文台区,32伍德斯托克路,牛津,OX2 6GG,英国,44 01865 617855,ben.goldacre@phc.ox.ac.uk %K处方%K NHS英格兰%K抗精神病药物%K盐酸丙嗪%K吡嗪%K临床审计%K数据科学%D 2022 %7 20.12.2022 %9原文%J JMIR Med Inform %G英文%X背景:数据分析用于识别提示治疗选择或临床结果变化的信号。迄今为止的分析通常集中在假设驱动的方法上。目的:本研究旨在建立一种无假设的方法来识别初级保健数据中的异常处方行为。我们的目标是将该方法应用于一项横断面研究中的国家数据集,以确定临床调试组(ccg)中使用差异显著的化学品,以进行进一步的临床审查,从而证明优先排序方法的概念。方法:在这里,我们报告了一种新的数据驱动的方法来识别初级保健数据中的异常处方行为。该方法首先应用一组过滤步骤来识别处方率分布可能包含异常值的化学物质,然后应用两种排序方法来识别这些候选物质中最极端的异常值。该方法已应用于三个月的国家处方数据(2017年6月至8月)。结果:我们的方法按行政区域提供了所有化学品的排名。 We provide illustrative results for 2 antipsychotic drugs of particular clinical interest: promazine hydrochloride and pericyazine, which rank highly by outlier metrics. Specifically, our method identifies that, while promazine hydrochloride and pericyazine are barely used by most clinicians (with national prescribing rates of 11.1 and 6.2 per 1000 antipsychotic prescriptions, respectively), they make up a substantial proportion of antipsychotic prescribing in 2 small geographic regions in England during the study period (with maximum regional prescribing rates of 298.7 and 241.1 per 1000 antipsychotic prescriptions, respectively). Conclusions: Our hypothesis-free approach is able to identify candidates for audit and review in clinical practice. To illustrate this, we provide 2 examples of 2 very unusual antipsychotics used disproportionately in 2 small geographic areas of England. %M 36538350 %R 10.2196/41200 %U https://medinform.www.mybigtv.com/2022/12/e41200 %U https://doi.org/10.2196/41200 %U http://www.ncbi.nlm.nih.gov/pubmed/36538350
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