采用临床风险预测工具的五个基本特征:从VOCAL-Penn得分的洞察力
Kinza Khan1, Mackenzie Bolas2, Nadim Mahmud2,3,4,5
1Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
五个关键因素:效率,可访问性,透明度,准确性和可通用性推动了医疗机构在肝硬化护理中采用医疗风险预测工具. 将工具设计与临床需求保持一致,对于广泛和公平的实施至关重要.
科学领域:
- 医疗信息学 医疗信息学
- 临床决策支持 临床决策支持
- 实施科学 实施科学
背景情况:
- 很少有医疗风险预测工具实现持续的临床采用.
- 肝硬化患者的手术风险计算器显示了广泛的使用.
- 了解影响提供商采用因素对于改进工具实施至关重要.
研究的目的:
- 确定影响提供商采用医疗风险预测工具的主要设计和实施因素.
- 使用VOCAL-Penn得分 (VPS) 作为一个案例,以探索临床医生的吸收.
- 制定一个框架,以加强风险预测工具的开发和传播.
主要方法:
- 这项定性研究涉及22名照顾肝硬化患者的不同临床医生.
- 半结构面试以"实施研究综合框架"为指导.
- 分析使用结合基础理论和演方法来合成新出现的主题.
主要成果:
- 五个反复出现的主题:效率,可访问性,透明度,准确性和可概括性.
- 临床医生优先考虑直观的工具,最小的输入,无的工作流集成和临床上有意义的变量.
- 信任和信誉是通过透明的模型开发和比较性绩效数据建立的.
结论:
- 效率,可访问性,透明度,准确性和通用性是未来工具开发的关键领域.
- 将工具设计与现实世界的临床需求结合起来,可以支持更广泛的采用.
- 该框架旨在改善医疗风险预测工具的公平实施.
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