论文标题

医疗保健员工的动态结核病筛查

Dynamic Tuberculosis Screening for Healthcare Employees

论文作者

Kiani, Mahsa, Isik, Tugce, Eksioglu, Burak

论文摘要

医疗保健员工可以与受感染的患者接触,需要定期进行结核病(TB)筛查。结核病是一种严重的,具有传染性且可能致命的疾病。即使是潜在的疾病,即使疾病的早期发现也可以防止疾病的传播并有助于治疗。目前,市场上有两种类型的结核病诊断测试:皮肤测试和血液检查。血液检查的成本远高于皮肤检查。但是,在皮肤测试中获得假阳性或假阴性结果的可能性更高,尤其是对于具有特定特征的人来说,这可能会增加成本。在这项研究中,我们将医疗保健员工分为多个风险群体,这些风险群体基于他们从事的部门,他们从事的特定工作以及他们的出生国。我们创建一个马尔可夫决策过程(MDP)模型,以决定每个员工组应进行哪个结核病测试,以最大程度地减少与测试,未发现感染,员工损失的时间有关的总成本。由于维度的诅咒,我们使用近似动态编程(ADP)获得了近乎最佳的解决方案。通过将此解决方案分析到ADP,我们不仅指定了应进行每个测试的类型,而且指定应进行每个测试的频率。基于此分析,我们提出了一项简单的政策,医疗机构可​​以使用,因为此类设施可能没有专业知识或资源来开发和解决复杂的优化模型。

Regular tuberculosis (TB) screening is required for healthcare employees since they can come into contact with infected patients. TB is a serious, contagious, and potentially deadly disease. Early detection of the disease, even when it is in latent form, prevents the spread of the disease and helps with treatment. Currently, there are two types of TB diagnostic tests on the market: skin test and blood test. The cost of the blood test is much higher than the skin test. However, the possibility of getting a false positive or false negative result in skin test is higher especially for persons with specific characteristics, which can increase costs. In this study, we categorize healthcare employees into multiple risk groups based on the department they work in, the specific job they do, and their birth country. We create a Markov decision process (MDP) model to decide which TB test should be taken by each employee group to minimize the total costs related to testing, undetected infections, employees' time lost. Due to the curse of dimensionality, we use approximate dynamic programming (ADP) to obtain a near-optimal solution. By analyzing this solution to the ADP we specify not only the type but the frequency with which each test should be taken. Based on this analysis, we propose a simple policy that can be used by healthcare facilities since such facilities may not have the expertise or the resources to develop and solve sophisticated optimization models.

扫码加入交流群

加入微信交流群

微信交流群二维码

扫码加入学术交流群,获取更多资源