计算机化临床决策支持系统对从业人员绩效和患者结果的影响:系统性审查
Amit X Garg1, Neill K J Adhikari, Heather McDonald
1Division of Nephrology, University of Western Ontario, London, Canada.
JAMA
|March 10, 2005
概括
计算机化临床决策支持系统 (CDSS) 显著提高医疗保健从业人员的绩效. 然而,它们对患者结局的影响需要进一步调查,目前的研究显示结果不一致.
科学领域:
- 医疗信息学 医疗信息学
- 改善临床实践的改善
- 基于证据的医学 基于证据的医学
背景情况:
- 医疗保健软件开发商声称,通过应用程序改善了患者护理.
- 临床试验是必要的,以验证这些健康干预的声明.
研究的目的:
- 系统地审查计算机化临床决策支持系统 (CDSS) 的受控试验.
- 确定预测CDSSs有益影响的研究特征.
主要方法:
- 在2004年9月之前,对多个数据库 (MEDLINE,EMBASE,Cochrane图书馆,Inspec,ISI) 进行了更新的系统审查.
- 包括100个随机和非随机受控试验,评估CDSS对从业人员表现或患者结果的影响.
- 两个审稿人对研究特征和结果进行独立的数据抽象.
主要成果:
- 在64%的研究中,CDSS提高了从业人员的表现.
- 具体的CDSS类型显示出不同的成功率:诊断 (40%),提醒 (76%),疾病管理 (62%) 和药物剂量/处方 (66%).
- 自动提示和开发者主导的研究与医生的表现改善有关 (分别P = .02和P = .001).
结论:
- 许多CDSS在改善医疗保健从业人员的表现方面表现出有效性.
- 目前,CDSS对患者结果的影响研究不足,并产生不一致的发现.
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