Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-05-10 Cooperative journals: 《中国全科医学》
Abstract： Heart failure is a cardiovascular disease that poses a serious health risk to the global population and is characterised by a chronic and prolonged disease course. Effective management centered on home care is essential for controlling symptoms and improving patient prognosis. Electronic health（e-health） technology is one of the hotspots in the research field of home management of heart failure，with the advantage of overcoming temporal and spatial barriers，and can achieve continuous monitoring，intelligent assessment，and dynamic management of the health status of patients at home. This paper systematically sorts out the related research on e-health in home management of patients with heart failure，and discusses its application value in drug management，exercise rehabilitation，symptom management，risk profile，and other aspects of patients with heart failure. It also analyzes and prospects the limitations of the e-health system such as poor digital inclusion，imperfect operation system， and risk of data security. The purpose of this study is to provide reference for the innovation of home management model for patients with heart failure.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2023-10-30 Cooperative journals: 《中国全科医学》
Abstract： Background The elderly are at high risk for acute pulmonary embolism（APE），and the difficulty of early identification and diagnosis of APE in the elderly has made the active search for an optimal prediction method for elderly patients with suspected APE a medical problem that must be faced. Objective To investigate the predictive value of the 4-level Clinical Pretest Probability Score（4PEPS）for pulmonary embolism（PE） in elderly patients with suspected APE. Methods Basic information and related clinical data were collected from elderly（age ≥ 60 years）hospitalized patients who completed spiral CT pulmonary arteriography（CTPA）examinations in the Third Affiliated Hospital of Zunyi Medical University from 2017 to 2021. The study subjects were divided into the APE group and non-APE group according to the CTPA criteria for the diagnosis of PE in 2018 Guidelines for the Diagnosis，Treatment and Prevention of Pulmonary Thromboembolism. The 4PEPS，Standard algorithm，AADD algorithm，YEARS algorithm and PEGeD algorithm were used to predict the APE of the study subjects，respectively，who were divided into the positive and negative groups，and the number of true positives， true negatives，false positives and false negatives of each prediction method was counted. The efficacy evaluation indexes of the five prediction method were calculated and their prediction values were compared. Results Among 1193 elderly hospitalized patients who completed CTPA examination，608（50.96%）were male and 585（49.04%）were female，with a median age of 74（68，81）years；323（27.07%）were APE patients and 870（72.93%）were non-APE patients; there was no statistically significant difference between elderly APE patients and elderly non-APE patients in terms of gender and age（P>0.05）. 4PEPS，AADD algorithm，Standard algorithm，YEARS algorithm and PEGeD algorithm for elderly patients with suspected APE had a sensitivity of 95.05%，97.83%，98.76%，97.21%，97.83%，the specificity of 31.84%，18.16%，12.87%，22.41%，22.41%，the correctness of 48.95%，39.73%，36.13%，42.67%，42.83%，Youden index of 0.27，0.16，0.12，0.20，0.20. The net reclassification improvement（NRI）of 4PEPS，Standard algorithm，YEARS algorithm and PEGeD algorithm compared to AADD algorithm were 0.218，-0.087，0.073，and 0.085，the difference of the NRI of 4PEPS compared to AADD algorithm was statistically significant（P<0.05）. Conclusion 4PEPS predicts elderly patients with suspected APE with high specificity，correctness，and Youden index，and the overall predictive value is significantly better than the remaining four methods，which may be the optimal prediction method for elderly patients with APE.
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