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Purpose/Significance To clarify the construction mode and key factors of data sharing in Chinese medical alliances,and to provide references for promoting data sharing in medical alliances.Method/Process Taking children's medical alliance of Yangtze River Delta as an example,Delphi method and qualitative interview method are used to explore the key contents and effect evaluation of specialty alliance construction,and the key factors of specialty alliance data sharing are defined based on the technology-organization-environment framework;SWOT analysis model is used to propose development strategies.Result/Conclusion Member hospitals are less satisfied with the construction effect of information interconnection.Key factors for realizing data sharing in specialty alliances include:support from government administrative departments,uniform and systematic compatibility of information standards,information security emergency response,patient privacy protection and informed consent,willingness of department directors to share,and internal communi-cation and compensation mechanism of alliances.
RESUMO
Objective To investigate the clinical characteristics of pulmonary hypertension(PH) in patients with chronic obstructive pulmonary disease (COPD) and study the related risk factors.Methods Patients with stable COPD enrolled in this study,undergoing examinations including full pulmonary function tests (PFT),6-minute walk distance (6MWD),Exercise Oxyhemoglobin,Saint.George's respiratory questionnaire (SGRQ) and transthoracic echocardiography.Pulmonary artery systolic pressure (sPAP) ≥ 36 mmHg(1 mmHg =0.133 kPa) was defined as PH.Results A total of 251 patients were finally evaluable in this study.The frequency of PH was 55.4％ (139/251) in patients with stable COPD.Significant differences were seen between patients with PH and without PH respectively in the following factors (mean P ＜0.05):proportion of age ≥ 60 years (69.8％ vs 57.1％),forced expiratory volume in one second (FEV1)(％ predicted) [(47.5±8.2)％ vs(61.2±10.2)％ and(49.8±7.9)％ vs(66.4±11.3)％],sPAP [(41.9 ± 9.1) mmHg vs (28.2 ± 3.2) mmHg],exercise oxyhemoglobin desaturation [(-5.5 ± 3.2) ％ vs(-2.2 ± 1.2) ％],6MWD [(316.0 ± 55.2) m vs(390.0 ±75.2) m].The following variables were negatively correlated with sPAP:6MWD (r =-0.330,P =0.003),FEV1 (％ predicted) (r =-0.210,P =0.024 and r =-0.130,P =0.012,respectively).The following variables were positively correlated with sPAP:age(r =0.560,P =0.031),exercise oxyhemoglobin desaturation ＞ 3％ (r =0.540,P =0.001).Logistic regression test has showed that age≥ 60 years,exercise oxygen desaturation ＞ 3％,FEV1 (％ predicted) ＜ 50％,6MWD ＜ 350 m were risk factors for PH in COPD.Conclusion The incidence of PH in COPD increases with age,yet the performance of lung function and the activity of endurance decrease in elder patients.Sixty years or older,exercise oxygen desaturation ＞ 3％,FEV1 (％ predicted) ＜ 50％,6MWD ＜ 350 m are risk factors of PH in COPD.Echocardiography or right heart catheterization when needed should be considered to confirm the diagnosis.