与电子健康记录相关的计算机决策支持系统的有效性:通过元分析进行更新的系统性审查
Annalisa Biffi1, Greta Castellini2, Gabriele Del Castillo3
1Laboratory of Healthcare Research & Pharmacoepidemiology, Department of Statistics and Quantitative Methods, Università degli Studi di Milano-Bicocca, Milan, Italy, National Centre for Healthcare Research and Pharmacoepidemiology, Milan, Italy.
International journal of medical informatics
|December 12, 2025
概括
与电子健康记录集成的计算机决策支持系统 (CDSS) 对死亡率几乎没有影响,但对发病率可能有很小的好处. 这些系统可以改善护理过程和临床医生的行为,可能会影响长期的健康结果.
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
- 基于证据的医学基于证据的医学.
背景情况:
- 集成到电子健康记录 (EHR) 中的计算机化决策支持系统 (CDSS) 旨在增强个人患者基于证据的临床决策.
- 进行了更新的系统审查,以评估CDSS与EHR患者数据相关的有效性.
研究的目的:
- 更新2014年关于CDSS与EHR集成的有效性的系统性审查.
- 评估CDSS对患者死亡率和发病率结果的影响.
主要方法:
- 在MEDLINE,Embase和Cochrane控制试验中央注册表上更新了搜索结果 (2013年1月~2023年1月).
- 包括随机对照试验 (RCT),评估与EHR集成的基于规则或算法的CDSS.
- 对死亡率和发病率结果进行的元分析,使用GRADE评估证据的确定性.
主要成果:
- 包括47个RCT;CDSS使用几乎没有降低死亡率 (中等确定性).
- 使用CDSS证明了对发病率 (高确定性) 的统计学上显著的,尽管很小的好处.
- 在心血管医学等特定领域可能产生小影响;改善护理流程和临床医生的行为.
结论:
- 与EHR集成的CDSS不会对死亡率产生重大影响,但可能会对发病率产生轻微改善.
- 这些系统显示出增强临床工作流程和临床医生的行为潜力,可能会影响长期健康.
- 进一步的研究可能会探索特定的治疗领域和CDSS实施的长期影响.
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