用临床决策支持系统进行试点研究
Agner R Parra Sánchez1,2, Koen Vos3, Odile van Hall2,4
1Department of Rheumatology and Clinical Immunology, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands a.r.parrasanchez@amsterdamumc.nl.
Lupus science & medicine
|August 22, 2025
概括
通过临床决策支持系统实施治疗目标策略在狼治疗中是可行的,可用的和可接受的. 这种方法支持主动调整治疗,而不会影响患者的满意度.
科学领域:
- 风湿病学和免疫学
- 卫生信息学
- 临床试验设计
背景情况:
- 系统性红斑狼 (SLE) 需要主动调整治疗.
- 治疗到目标 (T2T) 策略旨在通过实现预先定义的治疗目标来优化患者的结果.
- 临床决策支持系统 (CDSS) 可以帮助临床医生实施基于证据的治疗方案.
研究的目的:
- 评估SLE门诊治疗的T2T策略的可行性,可用性和可接受性.
- 评估CDSS支持的T2T方法对治疗修改和患者满意度的影响.
主要方法:
- 这是一项为期24周的非随机多中心试验,涉及SLE的成年患者.
- 患者被分配到T2T策略与CDSS (T2T- CDSS) 或常规门诊护理 (ROC) 中.
- 评估了可行性 (招聘,保留),可用性 (系统可用性量表) 和可接受性 (治疗满意度问卷,定性反). 探索性结局包括疾病活动和缓解率.
主要成果:
- 招募率为42% (38/91名患者),保留率为92% (35/38名患者).
- 该CDSS的可用性很好 (SUS得分为73.8).
- 在T2T-CDSS组中,治疗的强化和缓解 (糖皮质激素的逐渐减少) 发生更频繁;然而,在两组之间没有发现疾病活性或缓解率的显著差异.
结论:
- 通过CDSS支持的T2T策略的实施在常规SLE门诊护理中是可行的,可用的和可接受的.
- CDSS促进了主动的,以目标为导向的治疗调整,对SLE的目标导向治疗有希望.
- 解决发现的实施障碍对于未来的大规模试验至关重要.
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