Moehr Jochen R
School of Health Information Science, University of Victoria, RM A202, BOX 3050, Victoria, BC, Canada V8W 3P5.
Comput Biol Med. 2002 May;32(3):113-25. doi: 10.1016/s0010-4825(02)00009-4.
The currently prevailing paradigms of evaluation in medical/health informatics are reviewed. Some problems with application of the objectivist approach to the evaluation of real-rather than simulated-(health) information systems are identified. The rigorous application of the objectivist approach, which was developed for laboratory experiments, is difficult to adapt to the evaluation of information systems in a practical real-world environment because such systems tend to be complex, changing rapidly over time, and often existing in a variety of variants. Practical and epistemological reasons for the consequent shortcomings of the objectivist approach are detailed. It is argued that insistence on the application of the objectivist principles to real information systems may hamper rather than advance insights and progress because of this. Alternatives in the form of the subjectivist approach and extensions to both the objectivist and subjectivist approaches that circumvent the identified problems are summarized. The need to include systems engineering approaches in, and to further extend, the evaluation methodology is pointed out.
本文回顾了医学/健康信息学中当前流行的评估范式。识别了将客观主义方法应用于真实（而非模拟）（健康）信息系统评估时存在的一些问题。客观主义方法是为实验室实验而开发的，在实际的现实世界环境中，严格应用该方法难以适应信息系统的评估，因为此类系统往往复杂、随时间快速变化且常常存在多种变体。详细阐述了客观主义方法由此产生缺陷的实践和认识论原因。有人认为，由于这一点，坚持将客观主义原则应用于实际信息系统可能会阻碍而非促进见解和进展。总结了主观主义方法形式的替代方案以及规避已识别问题的客观主义和主观主义方法的扩展。指出了在评估方法中纳入系统工程方法并进一步扩展的必要性。
