基于算法的决策支持可用性测试的定性分析,用于跨癌症护理轨迹的症状管理:一种尺寸不适合所有人
Hayley Dunnack Yackel1, Barbara Halpenny2, Janet L Abrahm2
1Hartford HealthCare Cancer Institute, 80 Seymour Street, 06106, Hartford, CT, USA.
BMC medical informatics and decision making
|March 5, 2024
概括
癌症症状管理的临床决策支持 (CDS) 算法需要定制. 一种适合所有人的方法是无效的;对于不同的患者轨迹和护理环境,特别是对幸存者的初级护理,需要不同的工具.
科学领域:
- 在瘤学瘤学.
- 临床信息学 临床信息学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 癌症症状管理对于质量护理至关重要,但症状在整个疾病轨迹中演变.
- 无法控制的症状会导致严重的痛苦和医疗费用.
- 临床决策支持 (CDS) 提供了一条将基于指南的建议纳入实践的途径.
研究的目的:
- 开发和评估便秘和疲劳症状管理算法的可用性.
- 为了评估各种癌症护理轨迹和设置中的算法适用性.
主要方法:
- 根据国家临床实践指南 (CPG) 开发算法的修改 ADAPTE 过程.
- 使用性测试通过半结构面试与17名临床医生在综合性,社区癌症中心和初级保健.
- 对面试成绩单进行主题分析,并按护理环境进行交叉表格.
主要成果:
- 临床医生发现算法很有用,但强调了症状管理需求的显著差异.
- 主题显示出基于疾病,护理轨迹和关键的是护理环境的变化.
- 初级保健临床医生强调设置特定的策略,与积极治疗中心不同.
结论:
- CDS工具可以增强基于证据的症状管理.
- 一个通用的算法是不够的; 针对不同患者环境的定制CDS是必要的.
- 特定的CDS解决方案对于在初级保健机构管理的癌症幸存者至关重要.
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