基于计算机的临床决策支持系统的分类学描述。

A taxonomic description of computer-based clinical decision support systems.

作者信息

Berlin Amy, Sorani Marco, Sim Ida

机构信息

Department of Psychiatry, University of California, San Francisco, CA, USA.

出版信息

J Biomed Inform. 2006 Dec;39(6):656-67. doi: 10.1016/j.jbi.2005.12.003. Epub 2006 Jan 9.

DOI:10.1016/j.jbi.2005.12.003

PMID:16442854

Abstract

OBJECTIVE

Computer-based clinical decision support systems (CDSSs) vary greatly in design and function. Using a taxonomy that we had previously developed, we describe the characteristics of CDSSs reported in the literature.

METHODS

We searched PubMed and the Cochrane Library for randomized controlled trials (RCTs) published in English between 1998 and 2003 that evaluated CDSSs. We coded each CDSS using our taxonomy.

RESULTS

58 studies met our inclusion criteria. The 74 reported CDSSs varied greatly in context of use, knowledge and data sources, nature of decision support offered, information delivery, and workflow impact. Two distinct subsets of CDSSs were seen: patient-directed systems that provided decision support for preventive care or health-related behaviors via mail or phone (38% of systems), and inpatient systems targeting clinicians with online decision support and direct online execution of the recommendations (18%). 84% of the CDSSs required extra staffing for handling CDSS-related input or output.

CONCLUSION

Reported CDSSs are heterogeneous along many dimensions. Caution should be taken in generalizing the results of CDSS RCTs to different clinical or workflow settings.

摘要

目的

基于计算机的临床决策支持系统（CDSS）在设计和功能上差异很大。我们使用先前开发的分类法，描述文献中报道的CDSS的特征。

方法

我们在PubMed和Cochrane图书馆中检索了1998年至2003年间以英文发表的评估CDSS的随机对照试验（RCT）。我们使用分类法对每个CDSS进行编码。

结果

58项研究符合我们的纳入标准。报告的74个CDSS在使用背景、知识和数据源、提供的决策支持性质、信息传递以及工作流程影响方面差异很大。发现了两个不同的CDSS子集：通过邮件或电话为预防保健或健康相关行为提供决策支持的患者导向系统（占系统的38%），以及通过在线决策支持和直接在线执行建议针对临床医生的住院系统（占18%）。84%的CDSS需要额外的人员来处理与CDSS相关的输入或输出。