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画像要求のための臨床的意思決定支援システムの評価:クラスターランダム化臨床試験

画像要求のための臨床的意思決定支援システムの評価:クラスターランダム化臨床試験

Stijntje W Dijk ^1,2,3,4, Claudia Wollny ⁵, Joerg Barkhausen ⁶, Olav Jansen ⁷, Peter Mildenberger ⁸, Moritz C Halfmann ⁹, Jonas Stroeder ⁶, Dimitris Rizopoulos ², M G Myriam Hunink ^1,2,9, Thomas Kroencke ^5,10

Stijntje W Dijk ^1,2,3,4, Claudia Wollny ⁵, Joerg Barkhausen ⁶

¹Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
²Department of Epidemiology and Biostatistics, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
³Department of Gastroenterology and Hepatology, HagaZiekenhuis, the Hague, the Netherlands.
⁴Department of Radiology, Elisabeth-Tweesteden Ziekenhuis, Tilburg, the Netherlands.
⁵Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Augsburg, Germany.
⁶Department of Radiology and Nuclear Medicine, University of Lübeck, Lübeck, Germany.
⁷Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel, Germany.
⁸Department of Diagnostic and Interventional Radiology, University Medical Center Mainz, Mainz, Germany.
⁹Center for Health Decision Science, T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
¹⁰Centre for Advanced Analytics and Predictive Sciences, University of Augsburg, Augsburg, Germany.

⁰Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

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2025年2月10日

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PubMedで要約を見る

まとめ

この要約は機械生成です。

臨床的意思決定支援システム (CDSS) は,ドイツの学術病院における不適切な医療画像検査の要求を大幅に減少させなかった. この研究は,欧州放射線学会 iGuide

科学分野

医療用イメージング
医療情報学
臨床的意思決定支援

背景

医療イメージングは広く使用され,リソースの最適化と患者の結果のために適切性を改善するための介入が不可欠です.
臨床的意思決定支援システム (CDSS) が医師の注文行動に与える影響を評価することは極めて重要です.

研究の目的

欧州放射線学会 iGuide CDSSの有効性を評価し,医師による医療イメージングの適切な要求を改善する.
CDSSの実施が学術病院での医師の注文行動に与える影響を評価する.

主な方法

ドイツの3つの大学病院の26の部門でクラスターランダム化臨床試験が行われました.
この研究では,CDSSを備えた13の介入部門と,2.5年間の対照部門を比較した,前後設計を用いた.
差異の分析により,不適切な画像要求の割合の変化が評価されました.

主要な成果

合計65,764件の画像検査の要求が分析されました.
介入グループでは不適切な要求が平均で -0.5%減少し,対照群では -1.8%減少した.
不適切なイメージングの要求の統計的に有意な減少は示されなかった (P = .69).

結論

実施された臨床的意思決定支援システム (CDSS) は,不適切な医療イメージングの要求を統計的に有意に減少させなかった.
研究結果は,この特定のCDSSは,学術病院の設定における医師の注文行動を変えるのに効果的ではないことを示唆しています.
医学イメージングの適切性を改善するための代替戦略を探るには,さらなる研究が必要です.

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