Van Wyk J T, Van Wijk M A M
Institute of Medical Informatics, Erasmus Medical Center, PO Box 1738, 3000 DR Rotterdam, The Netherlands.
Stud Health Technol Inform. 2002;93:39-46.
Computerised decision support systems (CDSS) can be categorised as either being inquisitive or non-inquisitive. The non-inquisitive system uses routinely entered electronic patient data, to generate patient specific feedback based on guidelines. The Dutch College of General Practitioners' (DCGP) cholesterol guideline classifies patients into risk groups, eligible for screening. The availability of sufficient routinely recorded electronic patient data to classify patients according to the DCGP cholesterol guideline is unknown.
To assess whether it is possible to classify patients according to the screening criteria of the DCGP cholesterol guideline, using data routinely recorded by general practitioners.
We analysed the DCGP cholesterol guideline to identify selection criteria for screening. These selection criteria were subsequently used to create a cohort of patient records eligible for screening in the Integrated Primary Care Information (IPCI) Database. We calculated incidence and prevalence of risk factors and selected patient records for active management according to the identified screening selection criteria.
145866 valid patient records were selected for classification. In the retrieved records 9741 (13.6%) males and 5756 (7.8%) females were identified for active management according to the selection criteria of the DCGP cholesterol guideline.
The classification of patients into risk groups, eligible for screening, according to the criteria of the DCGP cholesterol guideline using routinely recorded electronic patient data is feasible. Care should be taken when using only diagnostic codes, as it gives higher than expected incidence and prevalence of risk factors. Based on these findings we are currently building Cholgate, a non-inquisitive decision support system for cholesterol management.
计算机化决策支持系统（CDSS）可分为询问式或非询问式。非询问式系统使用常规录入的电子患者数据，根据指南生成针对患者的反馈。荷兰全科医生学院（DCGP）的胆固醇指南将患者分为有资格接受筛查的风险组。目前尚不清楚是否有足够的常规记录电子患者数据来根据DCGP胆固醇指南对患者进行分类。
评估使用全科医生常规记录的数据，是否有可能根据DCGP胆固醇指南的筛查标准对患者进行分类。
我们分析了DCGP胆固醇指南，以确定筛查的选择标准。随后，这些选择标准被用于在综合初级保健信息（IPCI）数据库中创建一组有资格接受筛查的患者记录队列。我们计算了风险因素的发病率和患病率，并根据确定的筛查选择标准选择患者记录进行积极管理。
选择了145866份有效患者记录进行分类。在检索到的记录中，根据DCGP胆固醇指南的选择标准，确定有9741名（13.6%）男性和5756名（7.8%）女性需要进行积极管理。
使用常规记录的电子患者数据，根据DCGP胆固醇指南的标准将患者分为有资格接受筛查的风险组是可行的。仅使用诊断代码时应谨慎，因为它给出的风险因素发病率和患病率高于预期。基于这些发现，我们目前正在构建Cholgate，一个用于胆固醇管理的非询问式决策支持系统。
