Sim I, Gorman P, Greenes R A, Haynes R B, Kaplan B, Lehmann H, Tang P C
Department of Medicine, University of California-San Francisco, California 94143-0320, USA.
J Am Med Inform Assoc. 2001 Nov-Dec;8(6):527-34. doi: 10.1136/jamia.2001.0080527.
The use of clinical decision support systems to facilitate the practice of evidence-based medicine promises to substantially improve health care quality.
To describe, on the basis of the proceedings of the Evidence and Decision Support track at the 2000 AMIA Spring Symposium, the research and policy challenges for capturing research and practice-based evidence in machine-interpretable repositories, and to present recommendations for accelerating the development and adoption of clinical decision support systems for evidence-based medicine.
The recommendations fall into five broad areas--capture literature-based and practice-based evidence in machine--interpretable knowledge bases; develop maintainable technical and methodological foundations for computer-based decision support; evaluate the clinical effects and costs of clinical decision support systems and the ways clinical decision support systems affect and are affected by professional and organizational practices; identify and disseminate best practices for work flow-sensitive implementations of clinical decision support systems; and establish public policies that provide incentives for implementing clinical decision support systems to improve health care quality.
Although the promise of clinical decision support system-facilitated evidence-based medicine is strong, substantial work remains to be done to realize the potential benefits.
使用临床决策支持系统来促进循证医学实践有望大幅提高医疗质量。
基于2000年美国医学信息学会春季研讨会中证据与决策支持板块的会议记录,描述在机器可解释的知识库中获取基于研究和实践的证据所面临的研究和政策挑战,并提出加快开发和采用循证医学临床决策支持系统的建议。
这些建议分为五个广泛领域——在机器可解释的知识库中获取基于文献和实践的证据;为基于计算机的决策支持建立可维护的技术和方法基础;评估临床决策支持系统的临床效果和成本,以及临床决策支持系统影响专业和组织实践以及受其影响的方式;确定并传播对工作流程敏感的临床决策支持系统实施的最佳实践;制定公共政策,为实施临床决策支持系统以提高医疗质量提供激励措施。
尽管临床决策支持系统促进循证医学的前景广阔,但要实现潜在益处仍有大量工作要做。