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Computer prediction of neonatal outcome and comparison with assessments by physicians and midwives

机译:新生儿结局的计算机预测,并与医师和助产士进行的评估进行比较

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A simple statistical model for the prediction of 1' and 5' Apgar scores is implemented by computer and tested prospectively in 1000 deliveries. Data consist of model predictions in early labor and prior to delivery. Independent predictions of neonatal outcome by physicians and midwives are also included. While the predictive value of the original model is 81.6%, the overall predictive value of the computer model and of the physicians' assessments is only 67%. This finding is consistent irrespective of the time of prediction. Several factors are analyzed for possible association with the decrease in the model's predictive value. It is concluded that the development of a simple yet highly predictive model cannot be achieved. While measures for assessing the usefulness of the model need to take the effect of medical management into account, model optimization and the use of additional variables are indicated in order to improve sensitivity and specificity.
机译:通过计算机实现一个简单的统计模型,用于预测1'和5'Apgar得分,并在1000次交付中进行了预期性测试。数据包括早期分娩时和分娩前的模型预测。还包括医生和助产士对新生儿结局的独立预测。虽然原始模型的预测值为81.6%,但计算机模型和医生评估的总体预测值仅为67%。无论预测时间如何,这一发现都是一致的。分析了几个因素,以与模型预测值的降低可能相关。结论是,无法实现简单但高度可预测的模型的开发。虽然评估模型有用性的措施需要考虑到医疗管理的影响,但仍建议进行模型优化和使用其他变量,以提高敏感性和特异性。

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