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首页> 外文期刊>BMC Medical Informatics and Decision Making >Assessing the reliability of self-reported weight for the management of heart failure: application of fraud detection methods to a randomised trial of telemonitoring
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Assessing the reliability of self-reported weight for the management of heart failure: application of fraud detection methods to a randomised trial of telemonitoring

机译：评估自我报告体重对管理心力衰竭的可靠性：欺诈检测方法在远程监控随机试验中的应用

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Background Since clinical management of heart failure relies on weights that are self-reported by the patient, errors in reporting will negatively impact the ability of health care professionals to offer timely and effective preventive care. Errors might often result from rounding, or more generally from individual preferences for numbers ending in certain digits, such as 0 or 5. We apply fraud detection methods to assess preferences for numbers ending in these digits in order to inform medical decision making. Methods The Telemonitoring to Improve Heart Failure Outcomes trial tested an approach to telemonitoring that used existing technology; intervention patients ( n?= 826) were asked to measure their weight daily using a digital scale and to relay measurements using their telephone keypads. First, we estimated the number of weights subject to end-digit preference by dividing the weights?by five and comparing the resultant distribution with the uniform distribution. Then, we assessed the characteristics of patients reporting an excess number of weights ending in 0 or 5, adjusting for chance reporting of these values. Results Of the 114,867 weight readings reported during the trial, 18.6% were affected by end-digit preference, and the likelihood of these errors occurring increased with the number of days that had elapsed since trial enrolment (odds ratio per day: 1.002, p?Conclusions As well as overshadowing clinically meaningful changes in weight, end-digit preference can lead to false alerts?to telemonitoring systems, which may be associated with unnecessary treatment and alert fatigue. In this trial, end-digit preference was common and became increasingly so over time. By applying fraud detection methods to electronic medical data, it is possible to produce clinically significant information that can inform the design of initiatives to improve the accuracy of reporting. Trial registration ClinicalTrials.gov registration number NCT00303212 March 2006.
机译：背景技术由于心力衰竭的临床管理依赖于患者自行报告的体重，因此报告错误将对医疗保健专业人员提供及时有效的预防保健的能力产生负面影响。错误可能经常是由于四舍五入而引起的，或更普遍地，是由于个人对以某些数字（例如0或5）结尾的数字的偏爱。我们采用欺诈检测方法来评估对以这些数字结尾的数字的偏爱，以便为医疗决策提供依据。方法“改善心力衰竭结果的远程监护”试验测试了一种使用现有技术的远程监护方法。干预患者（n = 826）被要求每天使用数字秤测量体重，并使用电话键盘中继测量结果。首先，我们通过将权重α除以五，然后将所得的分布与均匀分布进行比较，来估计受末端数字优先权的权重数。然后，我们评估了报告过多重量以0或5结尾的患者的特征，调整了报告这些值的机会。结果在试验期间报告的114,867份体重读数中，有18.6％受末端数字首选项的影响，并且随着试验入组的天数增加，发生这些错误的可能性也随之增加（每天的比值比：1.002，p？结论除了掩盖临床上有意义的体重变化外，末端数字偏爱还可能导致对远程监控系统的虚假警报，这可能与不必要的治疗和警报疲劳有关。通过将欺诈检测方法应用于电子医疗数据，可以产生具有临床意义的信息，这些信息可以为计划的设计提供信息，从而提高报告的准确性试验注册ClinicalTrials.gov注册号NCT00303212 2006年3月。

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