Persell Stephen D, Dolan Nancy C, Baker David W
Division of General Internal Medicine, Feinberg School of Medicine, USA.
AMIA Annu Symp Proc. 2008 Nov 6:1090.
Clinical decision support can be used to capture the medical exceptions that justify deviations from guideline-based care. Peer review of this data is a potentially valuable and efficient means of identifying physician misconceptions or gaps in the medical knowledge base. Our early experience performing peer review on medical exceptions recorded through computerized point-of-care alerts shows that most medical exceptions were legitimate. Twelve percent of exceptions were inappropriate and 10% involved areas of considerable medical uncertainty.
临床决策支持可用于捕捉那些证明偏离基于指南的治疗是合理的医学例外情况。对这些数据进行同行评审是识别医生误解或医学知识库中差距的一种潜在有价值且高效的方法。我们早期对通过计算机化即时护理警报记录的医学例外情况进行同行评审的经验表明，大多数医学例外情况是合理的。12%的例外情况是不恰当的，10%涉及存在相当大医学不确定性的领域。
