Sakallaris B R, Jastremski C A, Von Rueden K T
APACHE Medical Systems, Suite 300, 1650 Tysons Blvd., McLean, VA 22102-3915, USA.
AACN Clin Issues. 2000 Aug;11(3):351-62. doi: 10.1097/00044067-200008000-00003.
Clinical decision support systems are the foundation for outcome management programs through the measurement of specific outcomes, data storage, data analysis, predictive modeling, and risk-adjusted comparison of actual outcomes with predicted outcomes. Many clinical decision support tools or databases are available to clinicians. This article reviews two widely available tools that provide clinical decision support for critical care clinicians, the Project IMPACT and APACHE III Critical Care Series clinical decision support systems. These tools are discussed with regard to risk adjustment methodology, validity, reliability, database size and representation, retrospective and prospective data and analysis, and quality control. Clinical application of clinical decision support systems for benchmarking and use in process improvement and outcome management is reviewed.
临床决策支持系统是通过特定结果的测量、数据存储、数据分析、预测建模以及实际结果与预测结果的风险调整比较来实现结果管理计划的基础。临床医生可以使用许多临床决策支持工具或数据库。本文回顾了两种广泛使用的为重症监护临床医生提供临床决策支持的工具，即“影响项目”（Project IMPACT）和“急性生理学及慢性健康状况评价系统Ⅲ（APACHE III）重症监护系列”临床决策支持系统。将从风险调整方法、有效性、可靠性、数据库规模和代表性、回顾性和前瞻性数据及分析以及质量控制等方面对这些工具进行讨论。还将回顾临床决策支持系统在基准比较以及过程改进和结果管理中的临床应用。
