Predictive Modeling of Physician-Patient Dynamics That Influence Sleep Medication Prescriptions and Clinical Decision-Making
| Autor: | Isaac S. Kohane, Andrew L. Beam, Arnaub K. Chatterjee, Uri Kartoun, Stanley Y. Shaw, Jennifer K. Pai, Timothy P. Fitzgerald |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Pyridines Clinical Decision-Making Affect (psychology) Drug Prescriptions Article Cohort Studies 03 medical and health sciences 0302 clinical medicine medicine Insomnia Odds Ratio Humans 030212 general & internal medicine Medical prescription Psychiatry Physician-Patient Relations Multidisciplinary business.industry Medical record Trazodone Odds ratio Models Theoretical 3. Good health Zolpidem Logistic Models Family medicine Cohort medicine.symptom business Sleep 030217 neurology & neurosurgery Cohort study medicine.drug |
| Zdroj: | Scientific Reports |
| ISSN: | 2045-2322 |
| Popis: | Insomnia remains under-diagnosed and poorly treated despite its high economic and social costs. Though previous work has examined how patient characteristics affect sleep medication prescriptions, the role of physician characteristics that influence this clinical decision remains unclear. We sought to understand patient and physician factors that influence sleep medication prescribing patterns by analyzing Electronic Medical Records (EMRs) including the narrative clinical notes as well as codified data. Zolpidem and trazodone were the most widely prescribed initial sleep medication in a cohort of 1,105 patients. Some providers showed a historical preference for one medication, which was highly predictive of their future prescribing behavior. Using a predictive model (AUC = 0.77), physician preference largely determined which medication a patient received (OR = 3.13; p = 3 × 10−37). In addition to the dominant effect of empirically determined physician preference, discussion of depression in a patient’s note was found to have a statistically significant association with receiving a prescription for trazodone (OR = 1.38, p = 0.04). EMR data can yield insights into physician prescribing behavior based on real-world physician-patient interactions. |
| Databáze: | OpenAIRE |
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