Bouaud Jacques, Messai Nizar, Laouénan Cédric, Mentré France, Séroussi Brigitte
AP-HP, STIM, Paris, France.
Stud Health Technol Inform. 2012;180:477-81.
Because they provide patient-specific guideline-based recommendations, clinical decision support systems (CDSSs) are expected to promote the implementation of clinical practice guidelines (CPGs). OncoDoc2 is a CDSS applied to the management of breast cancer. However, despite it was routinely used during weekly multidisciplinary staff meetings (MSMs) at the Tenon Hospital (Paris, France), the compliance rate of MSMs' decisions with CPGs did not reach 100%. Formal Concept Analysis (FCA) has been applied to elicit formal concepts related to non-compliance. A statistical pre-treatment of attributes has been proposed to leverage FCA and discriminate between compliant and non-compliant decisions. Among the 1,889 decisions made over a 3 year-period, 199 decisions of recommended re-excisions have been considered for analysis. In this sample, non-compliance was explained by uncommon clinical profiles and specific patient-centred clinical criteria.
由于临床决策支持系统（CDSS）能提供基于患者特定指南的建议，因此有望促进临床实践指南（CPG）的实施。OncoDoc2是一种应用于乳腺癌管理的CDSS。然而，尽管它在法国巴黎特农医院的每周多学科 staff meetings（MSMs）中被常规使用，但MSMs的决策与CPGs的符合率并未达到100%。形式概念分析（FCA）已被用于引出与不符合相关的形式概念。有人提出对属性进行统计预处理，以利用FCA并区分符合和不符合的决策。在3年期间做出的1889项决策中，有199项推荐再次切除的决策被纳入分析。在这个样本中，不符合是由不常见的临床特征和特定的以患者为中心的临床标准所解释的。
