用5个问题替代15个,实现远程术后恢复评估的高效预测。
AI-driven Optimisation of Quality of Recovery (QoR) in Remote Patient Monitoring

- 从15题中筛选出5题最优组合,保持预测精度。
- 5题版AUC达0.968,与原版几乎无差异。
- 适合需高频采集数据的远程康复场景。
远程患者监测依赖患者自报数据来捕捉设备无法测量的主观恢复维度。质量恢复量表(QoR-15)是该领域的金标准工具,最初设计用于医院偶发评估,现被用于每日远程监测。在我们自己的术后部署中,仅有55%的患者在30天监测期内提交超过14天的问卷。为此,我们开发了QoR-compact,一种适用于远程监测预测路径的五个项目日度输入。以每日三分之一项目为部署目标,我们系统评估了QoR-15所有3,003个五题子集,并检验其中最优者是否能与完整量表一样有效预测近期术后恢复严重程度。结果表明,QoR-compact的平均AUC-ROC达到0.968(95%置信区间0.915–0.988),与使用三分之一原始题项的基准值0.964统计上无显著差异。患者层面回测显示,其对再入院事件的追踪能力与完整量表相当。这五个题目覆盖了恢复的生理与心理维度:Q3(感到休息充分)、Q9(感觉舒适且有掌控感)、Q10(总体健康状况)、Q12(严重疼痛)、Q14(感到担忧或焦虑)。尽管QoR-15仍是恢复评估的金标准,但QoR-compact作为专为预测设计的轻量级日度输入,提供了可行替代方案。该性能一致性为未来研究更轻量输入能否提升完成率奠定了基础。在更大队列中进行外部验证前,尚不建议临床使用。
原文摘要 · Abstract (English)
Remote patient monitoring depends on patient-reported data to capture the subjective dimension of recovery that devices cannot measure. The Quality of Recovery (QoR-15) survey is the gold-standard instrument for this purpose. It was designed and validated for occasional in-hospital assessment, yet remote monitoring now administers it to patients daily. In our own post-surgical deployment, only 55% of patients submitted the survey more than 14 days of 30 monitoring days. We developed QoR-compact, a five-item daily input for the RPM prediction pathway. Setting a deployment-driven target of one-third of the daily items, we exhaustively evaluated all 3,003 five-question subsets of the QoR-15 and tested whether the best of them matches the full instrument in predicting near-term postoperative recovery severity. QoR-compact achieves a mean AUC-ROC of 0.968 (95% CI 0.915-0.988), statistically comparable to the 0.964 baseline obtained with one-third of the items. Patient-level backtesting indicates that it tracks readmission events as faithfully as the full form. Its five items span the physical and psychological axes of recovery: Q3 (feeling rested), Q9 (feeling comfortable and in control), Q10 (general well-being), Q12 (severe pain), and Q14 (feeling worried or anxious). The QoR-15 remains the gold-standard measure of recovery; QoR-compact complements it as a shorter daily input designed for prediction. This parity provides the basis for a prospective study of whether a lighter daily input is, in turn, completed more consistently. External validation on larger cohorts is required before clinical use.
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