Role of interactive survey in early diagnosis of chronic kidney diseases

Abstract

Objective. To conduct a comparative study of the prevalence of specific symptoms in patients with kidney damage using the automated program "Electronic Polyclinic" to optimize the algorithm for early diagnosis of chronic kidney disease.

Materials and methods. 18 patients of the therapeutic unit with kidney lesions, confirmed by laboratory and instrumental studies, as well as 7 healthy persons were examined. The main problems of patients were identified by the method of interactive questioning with the help of the program "Electronic Polyclinic". Further, a statistical analysis of the data and a comparative study with the control group of healthy persons were carried out using STATISTICA 12.0 program.

Results. The main symptoms of kidney damage were reliably determined and a low sensitivity of individual symptoms in the diagnosis, in contrast to the syndromic approach, was revealed. It showed that in 100 % of cases the automated program "Electronic Polyclinic" detected the syndromes, that indicates its high efficiency. An algorithm for early diagnosis of chronic kidney disease was proposed, which consists in an initial interactive survey followed by examination formulated by the computer program.

Conclusions. The method of interactive survey using the automated program "Electronic Polyclinic" allows you to effectively identify the syndromes of kidney damage, makes a preliminary diagnosis and draws up a plan of examination for further confirmation of the diagnosis. Symptomatic diagnosis has a number of disadvantages including low sensitivity and specificity, so it yields to syndromic diagnosis.

Keywords

Chronic kidney disease / early diagnosis / interactive questionnaire / syndrome

References

[1] Perm Region in numbers. 2019: A short statistical collection. Territorial body of the Federal State Statistics Service for the Perm Region. Perm 2019, available at: https://permstat.gks.ru/ storage/mediabank/пермский_край_в_цифрах2019(1).pdf. (in Russian).

[2] Пермский край в цифрах. 2019: Краткий статистический сборник. Территориальный орган Федеральной службы государственной статистики по Пермскому краю. Пермь 2019, available at: https://permstat. gks.ru/storage/mediabank/пермский_край_в_цифрах2019(1).pdf.

[3] Tariff agreement for 2019 and for the planning period of 2020 and 2021, approved at the meeting of the Commission for the Development of the Territorial program of Compulsory Medical Insurance of the Perm Region on 28.12.2018, protocol 12 of 28.12.2018. Appendix № 20. Perm 2018 (in Russian).

[4] Тарифное соглашение на 2019 год и на плановый период 2020 и 2021 годов. Утвержден на заседании Комиссии по разработке территориальной программы обязательного медицинского страхования Пермского края 28.12.2018, протокол от 28.12.2018 № 12. Приложение № 20. Пермь 2018.

[5] Tomilina N.A., Andrusev A.M., Peregudova N.G., Shinkarev M.B. Substitution therapy of terminal chronic renal failure. Report on the data of the All-Russian Register of Renal Replacement Therapy of the Russian Dialysis Society. Chast' pervaya. Nefrologiya i dializ 2017; 19(4): 1–95 (in Russian).

[6] Томилина Н.А., Андрусев А.М., Перегудова Н.Г., Шинкарев М.Б. Заместительная терапия терминальной хронической почечной недостаточности. Отчет по данным Общероссийского Регистра заместительной почечной терапии Российского диализного общества. Часть первая. Нефрология и диализ 2017; 19 (4): 1–95.

[7] Mishlanov V.Yu., Chuchalin V.A., Chereshnev A.V., Shubin I.V., Nikitin A.E. New Technologies in Rehabilitation of Patients with Respiratory Diseases. Prakticheskaya pulmonologiya 2019; 3: 28–31(in Russian).

[8] Мишланов В.Ю., Чучалин В.А., Черешнев А.В., Шубин И.В., Никитин А.Э. Новые технологии в реабилитации больных респираторными заболеваниями. Телемониторинг и телереабилитация. Практическая пульмонология 2019; 3: 28–31.

[9] Nagaytseva S.S. Prevalence, risk factors and the possibility of early detection of chronic kidney disease in residents of Central Russia on the example of the Kolomenskoye district of the Moscow region: avtoref. ... kand. med. nauk. Moscow; 2015; 24 (in Russian).

[10] Нагайцева С.С. Распространенность, факторы риски и возможность раннего выявления хронической болезни почек у жителей Центральной России на примере Коломенского района Московской области: автореф. … канд. мед. наук. М. 2015; 24.

[11] Mishlanov Ya.V., Mishlanov V.Yu., Mishlanova I.V., Mishlanova S.L. Certificate of state registration of the computer program "Electronic polyclinic" No. 2012614202, registration date 12.05.12 (in Russian).

[12] Мишланов Я.В., Мишланов В.Ю., Мишланова И.В., Мишланова С.Л. Свидетельство о государственной регистрации программы для ЭВМ «Электронная поликлиника» № 2012614202, дата регистрации 12.05.12.

[13] Chuchalin A.G., Chereshnev V.A., Mishlanov V.Yu., Mishlanov Ya.V., Nikitin A.E., Shubin I.V. Bioethics, artificial intelligence and medical diagnostics. Perm: PGMU 2019; 184 (in Russian).

[14] Чучалин А.Г., Черешнев В.А., Мишланов В.Ю., Мишланов Я.В., Никитин А.Э., Шубин И.В. Биоэтика, искусственный интеллект и медицинская диагностика. Пермь: ПГМУ 2019; 184.

[15] Mishlanov V., Chuchalin A., Chereshnev V., Poberezhets V., Vitacca M., Nevzorova V., Aisanov Z., Vizel A., Shubin I., Nikitin A., Zulkarneev R., Khovaeva Y. Scope and new horizons for implementation of m-Health/e-Health services in pulmonology in 2019. Monaldi Archives for Chest Disease. 2019; 89:1112.

[16] Mishlanov V., Chuchalin A., Chereshnev V., Poberezhets V., Vitacca M., Nevzorova V., Aisanov Z., Vizel A., Shubin I., Nikitin A., Zulkarneev R., Khovaeva Y. Scope and new horizons for implementation of m-Health/e-Health services in pulmonology in 2019. Monaldi Archives for Chest Disease 2019; 89:1112.

[17] Rebrova O. Yu. Statistical analysis of medical data. Application of the Statistica application software package. Moscow: MediaSfera 2000; 312 (in Russian).

[18] Реброва О. Ю. Статистический анализ медицинских данных. Применение пакета прикладных программ Statistica. М.: МедиаСфера 2000; 312.

[19] Katkova A.V., Mishlanov V.Yu., Zhigulev A.N. Interactive survey of lung cancer patients using the automated system "Electronic polyclinic". Povolzhskiy onkologicheskiy vestnik 2019; 2: 65–73 (in Russian).

[20] Каткова А.В., Мишланов В.Ю., Жигулев А.Н. Интерактивный опрос больных раком легкого с помощью автоматизированной системы «Электронная поликлиника». Поволжский онкологический вестник 2019; 2 (39): 65–73.

Funding

Исследование выполнено при финансовой поддержке РФФИ и Пермского края в рамках научного проектаThe study was carried out with the financial support of the Russian Foundation for Basic Research and the Perm Territory within the framework of scientific project(20-415-596008)

RIGHTS & PERMISSIONS

Burtseva E.A., Mishlanov V.Y., Anikeeva A.V., Selezneva V.I., Koshurnikova E.P., Chugainov S.V.