Schilling J, Faisst K, Kapetanios E, Norrie M, Gutzwiller F, Bertel O, Wyss P, Haller U
Institut für Sozial- und Präventivmedizin, Universität Zürich.
Schweiz Med Wochenschr. 1999 Jun 5;129(22):841-6.
In the last few years the basis for national guidelines for the indications of coronary angiography, coronary revascularisation and hysterectomy has been established. The guidelines have been published and are accessible to medical doctors and patients on the Internet using a database system called "Second Opinion System": http:/(/)sos.inf.ethz.ch Dissemination, implementation and validation of the guidelines will be of major importance in the near future. With reference to validation, the question remains whether the established guidelines are correct for the everyday treatment of patients. A suitable method of answering this important question is comparison between the appropriateness and necessity rates of the various indication groups, combined with outcome measurements. The Internet-based second opinion system (SOS) may be used for data collection in order to verify hypotheses. Because of the database architecture, only relevant information about the patients is collected via Internet, independent of time and place. In addition, the system allows users to evaluate their individual data, and special attention is given to data protection. The discussion about priorities in health care (rationing) will be increasingly important in the near future. The present project may offer a way of maintaining adequate access to health care services for patients. Therefore, the participation of as many institutions as possible in the project "quality assurance of indication and outcome in interventional cardiology and in gynaecology" is of great importance.
在过去几年里，冠状动脉造影、冠状动脉血运重建和子宫切除术适应症的国家指南基础已经确立。这些指南已发布，医生和患者可通过一个名为“第二意见系统”的数据库系统在互联网上获取：http:/(/)sos.inf.ethz.ch。在不久的将来，指南的传播、实施和验证将至关重要。关于验证，既定指南对患者日常治疗是否正确的问题依然存在。回答这个重要问题的一个合适方法是比较各适应症组的适宜性和必要性比率，并结合结果测量。基于互联网的第二意见系统（SOS）可用于数据收集以验证假设。由于数据库架构，仅通过互联网收集患者的相关信息，不受时间和地点限制。此外，该系统允许用户评估其个人数据，并特别注重数据保护。关于医疗保健优先事项（配给）的讨论在不久的将来将变得越来越重要。本项目可能提供一种方法，以确保患者能够充分获得医疗保健服务。因此，尽可能多的机构参与“介入心脏病学和妇科适应症及结果的质量保证”项目非常重要。
