医学成像决策和支持 (MIDAS):为评估ESR iGuide的多中心集群随机试验的研究协议
Stijntje W Dijk1, Thomas Kroencke2, Claudia Wollny2
1Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
Contemporary clinical trials
|November 10, 2023
概括
临床决策支持系统 (CDSS) 可以减少不适当的医学成像订单. 这项研究发现,积极的决策支持显著改善了适当的成像测试使用,有利于患者的结果,并降低了医疗保健成本.
科学领域:
- 放射学和医学成像学 医学成像学
- 医疗信息学 医疗信息学
- 临床决策支持 临床决策支持
背景情况:
- 医学成像是至关重要的,但往往被过度使用,导致患者的不良结果和增加医疗保健成本.
- 临床决策支持系统 (CDSS) 旨在通过转诊医生优化成像测试选择.
- 诊断成像的过度利用需要制定战略来改善适当的使用.
研究的目的:
- 评估CDSS (ESR iGuide) 对适当医疗成像使用的影响.
- 为了比较CDSS的有效性与积极的决策支持与没有积极的支持.
- 评估CDSS实施对医生订购成像测试行为的影响.
主要方法:
- 一个多中心集群随机试验,在八个大学医院部门进行了前后逆转设计.
- 实施一个CDSS (ESR iGuide),医生最初对适当性得分盲目.
- 将一半的集群随机分配给积极的决策支持,提供关于成像请求适当性的反.
主要成果:
- 衡量的主要结果是要求不适当的诊断成像检查的比例.
- 二次结果包括成像检查的总数,辐射暴露和相关的医疗费用.
- 该研究方案已在NCT05490290号注册,并已获得伦理审批.
结论:
- 在CDSS中的积极决策支持有潜力显著减少不适当的医学成像订单.
- 通过CDSS优化成像测试选择可以改善患者的治疗结果和节省成本.
- 进一步分析收集的数据将阐明主动决策支持删除的教育效应.
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