Evidence map›Paper›PMID 39476375›Full record

ArticleJournal of medical Internet research2024

Evolution of the "Internet Plus Health Care" Mode Enabled by Artificial Intelligence: Development and Application of an Outpatient Triage System.

Lingrui Yang, Jiali Pang, Song Zuo, Jian Xu, Wei Jin, Feng Zuo, Kui Xue, Zhongzhou Xiao, Xinwei Peng, Jie Xu and 5 more

Abstract read
In one paragraph

Article in Journal of medical Internet research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Lingrui Yang *Clinical Research and Innovation Unit, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.ORCID 0009-0005-4902-1034
Jiali Pang *Shanghai Artificial Intelligence Laboratory, Shanghai, China.ORCID 0000-0001-5757-4804
Song ZuoClinical Research and Innovation Unit, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.ORCID 0009-0005-4262-692X
Jian XuClinical Research and Innovation Unit, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.ORCID 0009-0006-9663-7285
Wei JinClinical Research and Innovation Unit, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.ORCID 0009-0003-0813-7626
Feng ZuoClinical Research and Innovation Unit, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.ORCID 0000-0003-1582-3221
Kui XueShanghai Artificial Intelligence Laboratory, Shanghai, China.ORCID 0009-0009-9601-5349
Zhongzhou XiaoShanghai Artificial Intelligence Laboratory, Shanghai, China.ORCID 0000-0001-8423-1356
Xinwei PengShanghai Artificial Intelligence Laboratory, Shanghai, China.ORCID 0000-0001-9868-0136
Jie XuShanghai Artificial Intelligence Laboratory, Shanghai, China.ORCID 0000-0001-9233-4363
Xiaofan ZhangShanghai Artificial Intelligence Laboratory, Shanghai, China.ORCID 0000-0003-3999-1449
Ruiyao ChenShanghai Artificial Intelligence Laboratory, Shanghai, China.ORCID 0000-0002-2011-5556
Shuqing LuoShanghai Artificial Intelligence Laboratory, Shanghai, China.ORCID 0000-0003-4872-3315
Shaoting Zhang *Shanghai Artificial Intelligence Laboratory, Shanghai, China.ORCID 0000-0002-8719-448X
Xin Sun *Clinical Research and Innovation Unit, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.ORCID 0009-0003-7223-5298

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough new technologies have increased the efficiency and convenience of medical care, patients still struggle to identify specialized outpatient departments in Chinese tertiary hospitals due to a lack of medical knowledge.

objectiveThe objective of our study was to develop a precise and subdividable outpatient triage system to improve the experiences and convenience of patient care.

methodsWe collected 395,790 electronic medical records (EMRs) and 500 medical dialogue groups. The EMRs were divided into 3 data sets to design and train the triage model (n=387,876, 98%) and test (n=3957, 1%) and validate (n=3957, 1%) it. The triage system was altered based on the current BERT (Bidirectional Encoder Representations from Transformers) framework and evaluated by recommendation accuracies in Xinhua Hospital using the cancellation rates in 2021 and 2022, from October 29 to December 5. Finally, a prospective observational study containing 306 samples was conducted to compare the system's performance with that of triage nurses, which was evaluated by calculating precision, accuracy, recall of the top 3 recommended departments (recall@3), and time consumption.

resultsWith 3957 (1%) records each, the testing and validation data sets achieved an accuracy of 0.8945 and 0.8941, respectively. Implemented in Xinhua Hospital, our triage system could accurately recommend 79 subspecialty departments and reduce the number of registration cancellations from 16,037 (3.83%) of the total 418,714 to 15,338 (3.53%) of the total 434200 (P<.05). In comparison to the triage system, the performance of the triage nurses was more accurate (0.9803 vs 0.9153) and precise (0.9213 vs 0.9049) since the system could identify subspecialty departments, whereas triage nurses or even general physicians can only recommend main departments. In addition, our triage system significantly outperformed triage nurses in recall@3 (0.6230 vs 0.5266; P<.001) and time consumption (10.11 vs 14.33 seconds; P<.001).

conclusionsThe triage system demonstrates high accuracy in outpatient triage of all departments and excels in subspecialty department recommendations, which could decrease the cancellation rate and time consumption. It also improves the efficiency and convenience of clinical care to fulfill better the usage of medical resources, expand hospital effectiveness, and improve patient satisfaction in Chinese tertiary hospitals.

Indexed as

Artificial IntelligenceTriageChinaElectronic Health RecordsHumansInternetOutpatientsProspective Studiesall department recommendationartificial intelligence“internet plus health care”“internet plus healthcare”subspecialty department recommendationtriage system

Identifiers

PMID39476375
PMCPMC11561436

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.