在混合实施-有效性试验中评估用于心房的节律控制的数字决策辅助器
Meghan Reading Turchioe1, Afra Shamnath2, David Slotwiner3
1Columbia University School of Nursing, New York, NY, USA. mr3554@cumc.columbia.edu.
NPJ digital medicine
|March 6, 2026
概括
数字决策辅助工具对共享决策充满希望,但实际实施面临挑战. 根据患者的准备,识字能力和临床背景,有效性各不相同,这凸显了需要针对性地部署这些工具的必要性.
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
- 患者参与 患者参与
背景情况:
- 数字决策辅助工具可以加强共享决策,但在临床实践中面临实施障碍.
- 前庭动节律控制决策辅助工具旨在改善患者与临床医生的沟通和决策质量.
研究的目的:
- 使用RE-AIM框架评估数字心房动节律控制决策辅助器的实施有效性.
- 评估接受数字决策辅助工具的老年人决策质量和实施结果.
主要方法:
- 一个混合型2实施-有效性试验,涉及75名老年人在两个临床场所.
- 使用RE-AIM框架来衡量采用,覆盖范围,有效性,采用和维护.
- 评估决策质量,决策冲突,自我有效性和定性反.
主要成果:
- 数字决策辅助工具表现出高度接受度和广泛采用.
- 在整个队列中没有观察到决定性冲突和自我有效性的显著平均改善.
- 有效性各不相同,最佳结果与患者的准备,健康素养和临床背景有关.
结论:
- 在现实世界临床工作流程中部署数字干预措施存在挑战.
- 根据患者的准备,识字能力和护理背景来定位决策支持工具对于最大限度地提高有效性至关重要.
- 个性化交付策略对于优化不同患者群体的数字健康干预措施至关重要.
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