St George Ian, Cullen Matthew, Branney Michelle
Healthline, Wellington, New Zealand.
N Z Med J. 2005 Oct 28;118(1224):U1693.
To assess agreement between the advice to symptomatic callers to Healthline, and that advised by primary care doctors given the same clinical information, and thus to assess the safety of Healthline advice.
Ninety records of symptomatic calls to Healthline were examined by three primary care specialists, blinded to the actual advice given. They independently recorded what they would have advised, and their advice was compared with that actually given by the Healthline nurse guided by Care Enhance Call Centre software.
Variation among the three doctors was greater than that between the median doctor and Healthline. In 82% of cases, the median doctor triaged to an endpoint close to (or lower than) Healthline. In all but one of the remainder, at least one doctor thought there was no risk to the patient (i.e. in 99% of cases). Review of that case indicated nurse error and the guideline itself was judged to be safe.
New Zealand primary care specialists regarded the Care Enhance Call Centre decision support software used by Healthline as clinically safe.
评估向拨打健康热线的有症状来电者提供的建议与在给出相同临床信息时初级保健医生所建议的内容之间的一致性，从而评估健康热线建议的安全性。
三位初级保健专家检查了90个拨打健康热线的有症状来电记录，他们不知道实际给出的建议。他们独立记录自己会给出的建议，并将他们的建议与由Care Enhance呼叫中心软件指导的健康热线护士实际给出的建议进行比较。
三位医生之间的差异大于中位医生与健康热线之间的差异。在82%的病例中，中位医生将患者分诊到与健康热线相近（或低于健康热线）的终点。在其余病例中，除了一例之外，至少有一位医生认为对患者没有风险（即99%的病例）。对该病例的审查表明护士存在失误，并且该指南本身被判定是安全的。
新西兰初级保健专家认为健康热线使用的Care Enhance呼叫中心决策支持软件在临床上是安全的。
