面向患者的在线选工具和临床医生的决策:系统性审查
Armina Paule1, Gary A Abel2, Jo Parsons3
1Applied Health, Warwick Medical School, University of Warwick, Coventry, UK armina.paule@warwick.ac.uk.
BMJ open
|May 9, 2025
概括
面向患者的在线分选工具影响初级保健临床决策,影响患者的结果和从业人员的经验. 对临床医生和开发人员来说,意识到改变的决策过程是关键.
科学领域:
- 数字健康数字健康
- 初级医疗保健医学 一级医疗保健医学
- 临床决策支持系统 临床决策支持系统
背景情况:
- 面向患者的在线选工具越来越多地用于初级保健.
- 了解它们对临床决策的影响对于有效实施至关重要.
- 现有的文献缺乏对这些工具如何影响临床医生选择的综合概述.
研究的目的:
- 系统地审查和评估面向患者的在线分拣工具在初级保健临床决策中的作用.
- 确定对患者临床结果,初级保健医师经验和医疗保健系统结果的影响.
主要方法:
- 2002年1月至2024年11月期间发表的研究的系统审查.
- 搜索的数据库:Medline,Embase,CINAHL,科学网,Scopus. 这些数据库中的一个是:
- 包括任何设计研究临床医生决策的研究,以响应在线分拣工具输入;使用叙事合成进行分析.
主要成果:
- 包括14项研究 (英国,瑞典,西班牙);没有研究直接测量临床决策作为结果.
- 报告中的影响包括更快的决策,以及由于患者"游戏"而不必要的紧急预约.
- 临床医生报告说,随着额外的信息 (例如照片) 和节省时间,他们的信心增加了,尽管工具有时被视为额外的工作流程步骤.
结论:
- 当使用在线分选工具时,临床医生的决策过程会发生变化.
- 工具开发人员可以提高可用性,以更好地支持临床决策.
- 未来的研究应该专注于这些工具在一般实践和临床决策过程本身.
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