Adang R P, Vismans F J, Ambergen A W, Talmon J L, Hasman A, Flendrig J A
Department of Internal Medicine, University Hospital, Maastricht, The Netherlands.
Int J Biomed Comput. 1991 Oct;29(1):31-44. doi: 10.1016/0020-7101(91)90011-3.
The aim of this prospective study was to assess the applicability of a computerised medical history system at the open-access endoscopy unit of a University Hospital during routine clinical practice. We studied feasibility, acceptability and reproducibility of computerised questionnaires designed for patients referred for endoscopy of either the upper or lower gastrointestinal (GI) tract, partly in comparison with almost identical paper questionnaires. In the first period of the study 1134 patients were referred of whom 73% answered the paper questionnaire, and during the second period 537 patients were referred of whom 64% answered the computerised questionnaire (P less than 0.001). There was no sex dependency regarding the ability to answer both types of questionnaires. A significant age dependency regarding the ability to answer the paper questionnaires was observed for patients referred for upper and lower GI endoscopy (P less than 0.0001 and P less than 0.0001). Corresponding with this observation, the ability to answer the computerised questionnaires significantly decreased with increasing age for both groups of patients (P less than 0.0001 and P less than 0.0001). The average completion times of both computerised questionnaires, designed for the upper and lower GI tract, were 11 min. The completion times did not depend on sex, but there was a slight positive correlation with age (P less than 0.0001 with multiple R = 0.27 and P = 0.0593 with multiple R = 0.12). Answering our computerised questionnaires was consistently reported to be interesting and easy, and did not last too long according to the respondents. After patients had answered the computerised history system, the insight into their complaints had increased in 40%, and 45% could put their complaints into words more easily. Only 25% of the patients were unable to express all their complaints. A reproducibility of medical history data of 85% was observed between paper and computerised questionnaires. Our computerised questionnaires can provide us with a detailed and uniformly acquired medical history of most patients referred for GI endoscopy. They are well accepted by the patients and can be completed during the normal waiting period. The medical history data obtained with these questionnaires are quite reproducible.
这项前瞻性研究的目的是评估在大学医院的开放式内镜检查科室,计算机化病史系统在常规临床实践中的适用性。我们研究了为上消化道或下消化道内镜检查患者设计的计算机化问卷的可行性、可接受性和可重复性,并部分与几乎相同的纸质问卷进行了比较。在研究的第一阶段,有1134名患者被转诊,其中73%回答了纸质问卷;在第二阶段,有537名患者被转诊,其中64%回答了计算机化问卷(P<0.001)。回答这两种问卷的能力不存在性别差异。对于接受上消化道和下消化道内镜检查的患者,回答纸质问卷的能力存在显著的年龄差异(P<0.0001和P<0.0001)。与此观察结果一致,两组患者回答计算机化问卷的能力均随年龄增长而显著下降(P<0.0001和P<0.0001)。为上消化道和下消化道设计的两种计算机化问卷的平均完成时间均为11分钟。完成时间不取决于性别,但与年龄存在轻微正相关(多重相关系数R = 0.27时P<0.0001,多重相关系数R = 0.12时P = 0.0593)。据受访者称,回答我们的计算机化问卷一直被认为很有趣且容易,并且不会持续太长时间。患者回答计算机化病史系统后,对自身症状的了解增加了40%,45%能够更轻松地描述自己的症状。只有25%的患者无法表达所有症状。纸质问卷和计算机化问卷之间的病史数据可重复性为85%。我们的计算机化问卷可以为大多数接受胃肠内镜检查的患者提供详细且统一获取的病史。它们很受患者欢迎,并且可以在正常等待期间完成。通过这些问卷获得的病史数据具有相当高的可重复性。