相关实验视频
基于计算机的临床决策支持系统对医生的表现和患者结果的影响:系统性审查
D L Hunt1, R B Haynes, S E Hanna
1Department of Clinical Epidemiology and Biostatistics, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada.
JAMA
|October 30, 1998
概括
基于计算机的临床决策支持系统 (CDSS) 在改善医生的表现方面表现有前途,特别是在药物剂量和预防性护理方面. 然而,它们对患者结果的影响需要进一步调查,诊断应用显示的结果不那么令人信服.
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:
- 声称软件系统可以改进临床决策需要严格的评估.
- 评估包括技术在内的医疗保健干预措施对临床表现和患者结果的影响至关重要.
研究的目的:
- 系统地审查基于计算机的临床决策支持系统 (CDSS) 的受控临床试验.
- 评估CDSS对医生的表现和患者结果的影响.
主要方法:
- 更新了对1992年至1998年的受控临床试验的系统审查,搜索了多个文献数据库.
- 包括的研究涉及CDSS在临床环境中的使用,具有前性评估和并发性对照.
- 评估了研究的有效性,并抽象了有关环境,受试者,系统和结果的数据.
主要成果:
- 包括68项受控试验;1992年以后发表的40项,随着时间的推移质量得到改善.
- 在65项研究中,CDSS在66%的研究中证明了医生表现的好处,特别是在药物剂量和预防性护理方面.
- 在14项研究中,只有6项研究显示对患者的结果有好处,许多研究缺乏足够的功率来检测效应.
结论:
- 关于CDSS的研究数量和质量正在增加.
- CDSS可以在药物剂量和预防性护理等领域改善临床性能,但对于诊断来说并不令人信服.
- CDSS对患者治疗结果的影响仍未得到充分研究,因此需要进行更严格的研究.
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