Wellwood J, Johannessen S, Spiegelhalter D J
MRC Biostatistics Unit, Cambridge.
Ann R Coll Surg Engl. 1992 Jan;74(1):40-6.
The introduction of standardised data-collection forms and computer-aided diagnosis has been found to be associated with improved diagnosis and management of patients with acute abdominal pain. The mechanism by which such benefits accrue has been the subject of some controversy. Detailed analysis of 5193 patients from one hospital shows that the major benefit from such diagnostic aids was the accurate early diagnosis of non-specific abdominal pain by senior house officers in the accident and emergency department; this in turn led to fewer admissions and fewer operations with negative findings. Clinical data about patients with acute abdominal pain should be recorded on structured information sheets by junior doctors and early positive diagnosis should be encouraged before decisions affecting the patient's management are made. Improved computer support may confer further benefits.
标准化数据收集表和计算机辅助诊断的引入已被发现与改善急性腹痛患者的诊断和管理相关。产生这些益处的机制一直存在一些争议。对一家医院的5193名患者进行的详细分析表明,此类诊断辅助工具的主要益处是急诊部门的住院医生对非特异性腹痛进行准确的早期诊断;这反过来又减少了住院人数和阴性结果的手术数量。初级医生应在结构化信息表上记录急性腹痛患者的临床数据,并应在做出影响患者管理的决定之前鼓励早期做出阳性诊断。改进的计算机支持可能会带来更多益处。