Sanders David L, Aronsky Dominik
Dept. of Biomedical Informatics, Eskind Biomedical Library, Vanderbilt University Medical Center, 2209 Garland Ave, Nashville, TN 37232-8340, USA.
J Am Med Inform Assoc. 2006 Jul-Aug;13(4):418-27. doi: 10.1197/jamia.M2039. Epub 2006 Apr 18.
Asthma is a common condition associated with significant patient morbidity and health care costs. Although widely accepted evidence-based guidelines for asthma management exist, unnecessary variation in patient care remains. Application of biomedical informatics techniques is one potential way to improve care for asthmatic patients. We performed a systematic literature review to identify computerized applications for clinical asthma care. Studies were evaluated for their clinical domain, developmental stage and study design. Additionally, prospective trials were identified and analyzed for potential study biases, study effects, and clinical study characteristics. Sixty-four papers were selected for review. Publications described asthma detection or diagnosis (18 papers), asthma monitoring or prevention (13 papers), patient education (13 papers), and asthma guidelines or therapy (20 papers). The majority of publications described projects in early stages of development or with non-prospective study designs. Twenty-one prospective trials were identified, which evaluated both clinical and non-clinical impacts on patient care. Most studies took place in the outpatient clinic environment, with minimal study of the emergency department or inpatient settings. Few studies demonstrated evidence of computerized applications improving clinical outcomes. Further research is needed to prospectively evaluate the impact of using biomedical informatics to improve care of asthmatic patients.
哮喘是一种常见病症，会给患者带来严重的发病情况和医疗费用。尽管存在广泛认可的基于证据的哮喘管理指南，但患者护理中仍存在不必要的差异。应用生物医学信息学技术是改善哮喘患者护理的一种潜在方法。我们进行了一项系统的文献综述，以确定用于临床哮喘护理的计算机化应用。对研究的临床领域、发展阶段和研究设计进行了评估。此外，还对前瞻性试验进行了识别和分析，以了解潜在的研究偏差、研究效果和临床研究特征。选择了64篇论文进行综述。出版物描述了哮喘检测或诊断（18篇论文）、哮喘监测或预防（13篇论文）、患者教育（13篇论文）以及哮喘指南或治疗（20篇论文）。大多数出版物描述的是处于开发早期阶段或采用非前瞻性研究设计的项目。确定了21项前瞻性试验，这些试验评估了对患者护理的临床和非临床影响。大多数研究在门诊环境中进行，对急诊科或住院环境的研究很少。很少有研究证明计算机化应用能改善临床结果。需要进一步研究以前瞻性地评估使用生物医学信息学改善哮喘患者护理的影响。
