基于区域网络过程数据多源监测的医疗保健相关感染的自动聚类检测:卡塔尔世界杯8强波胆分析华中科技大学同济医学院附属协和医院医院感染管理科(武汉解放大道1277号，1 86 02785726293)lijuanxiong2016@126.com %K卫生保健相关感染%K群集检测%K早期预警%K多源监测%K处理数据%D 2020 %7 23.10.2020 %9原始论文%J JMIR Med Inform %G英文%X背景:卫生保健相关感染(HAIs)的群集检测对于在早期阶段识别HAI暴发至关重要。目的:我们旨在验证基于区域网络过程数据的多源监测是否可以有效地检测HAI集群。方法:回顾性分析国内某三级医院4个独立高危单位HAIs的发生率及与感染相关的3个流程数据指标，即联合抗生素使用率、细菌标本检出率和细菌标本阳性率。我们利用Shewhart预警模型来检测时间序列数据的峰值。随后，我们基于过程数据设计了5种监控策略用于HAI聚类检测:(1)单组抗生素利用率，(2)单组细菌标本检查率，(3)单组细菌标本阳性率，(4)单组抗生素利用率+单组细菌标本检查率+单组细菌标本阳性率，(5)单组抗生素利用率+单组细菌标本检查率+单组细菌标本阳性率。我们使用受试者工作特征(ROC)曲线和约登指数来评估这些监测策略对HAI集群检测的预警性能。结果:5种监测策略的ROC曲线均位于标准线以上，并行策略的ROC曲线下面积大于串联策略和单指标策略。 The optimal Youden indexes were 0.48 (95% CI 0.29-0.67) at a threshold of 1.5 in the antibiotic utilization rate in combination–only strategy, 0.49 (95% CI 0.45-0.53) at a threshold of 0.5 in the inspection rate of bacterial specimens–only strategy, 0.50 (95% CI 0.28-0.71) at a threshold of 1.1 in the positive rate of bacterial specimens–only strategy, 0.63 (95% CI 0.49-0.77) at a threshold of 2.6 in the parallel strategy, and 0.32 (95% CI 0.00-0.65) at a threshold of 0.0 in the series strategy. The warning performance of the parallel strategy was greater than that of the single-indicator strategies when the threshold exceeded 1.5. Conclusions: The multisource surveillance of process data in the area network is an effective method for the early detection of HAI clusters. The combination of multisource data and the threshold of the warning model are 2 important factors that influence the performance of the model. %M 32965228 %R 10.2196/16901 %U http://medinform.www.mybigtv.com/2020/10/e16901/ %U https://doi.org/10.2196/16901 %U http://www.ncbi.nlm.nih.gov/pubmed/32965228