Minne Lilian, Dongelmans Dave A, de Jonge E, Abu-Hanna Ameen
Academic Medical Center, Department of Medical Informatics, Amsterdam, the Netherlands.
Stud Health Technol Inform. 2012;180:1060-4.
In the Intensive Care Unit, clinicians are continuously faced with the difficult task of prognosis, but their predictions of patient survival status may not always be consistent. Specifically very little is known about consistency of predictions over time. The aim of this paper is to assess the consistency of nurses' daily predictions of survival in terms of inter-observer variance and variance of observers over time. We found a low consistency of these predictions between observers and over time, even though changes in the patients' condition are considered. Our findings have implications to the process of end-of-life decision-making, which pertains to withholding or withdrawing intensive care treatment.
在重症监护病房，临床医生不断面临预后的艰巨任务，但他们对患者生存状况的预测并不总是一致的。具体而言，关于预测随时间的一致性知之甚少。本文的目的是从观察者间差异和观察者随时间的差异方面评估护士对生存的每日预测的一致性。我们发现，即使考虑到患者病情的变化，观察者之间以及随时间推移这些预测的一致性也很低。我们的研究结果对临终决策过程有影响，这涉及到停止或撤销重症监护治疗。
