做检测还是不做：一项基于注册登记的关于前列腺特异性抗原检测在线决策支持的观察性研究。

To test or not: a registry-based observational study of an online decision support for prostate-specific antigen tests.

作者信息

Mukai Thomas Ostersen, Bro Flemming, Olesen Frede, Vedsted Peter

机构信息

The Research Unit for General Practice, School of Public Health, Aarhus University, Bartholins Allé 2, DK-8000 Aarhus C, Denmark; Section for General Medical Practice, School of Public Health, Aarhus University, Bartholins Allé 2, DK-8000 Aarhus C, Denmark; Research Centre for Cancer Diagnosis in Primary Care - CaP, Aarhus University, Bartholins Allé 2, DK-8000 Aarhus C, Denmark.

The Research Unit for General Practice, School of Public Health, Aarhus University, Bartholins Allé 2, DK-8000 Aarhus C, Denmark.

出版信息

Int J Med Inform. 2013 Oct;82(10):973-9. doi: 10.1016/j.ijmedinf.2013.06.010. Epub 2013 Jul 11.

DOI:10.1016/j.ijmedinf.2013.06.010

PMID:23850383

Abstract

BACKGROUND

Watchful waiting is an essential part in the handling of patients with prostate cancer (PC). More effective disease management may be achieved by this strategy. Correct use of prostate-specific antigen (PSA) test is crucial and the general practitioner (GP) may therefore benefit from access to a clinical decision support system (CDSS) that focuses on this challenge. There are many barriers to the use of CDSSs. The aim of the present paper is to study if such barriers may be overcome by granting GPs easier access to a web-based CDSS via a hyperlink in the GPs' electronic medical record system (EMR).

METHODS

In the present population-based observational registry study with an intervention and control group, we created a web-based CDSS that was made accessible to GPs via hyperlink inserted into the EMR medical chart contents. The intervention was introduced 1 January 2011. Our outcome measure was the number of age-standardised PSA test rates per 1000 men per practice during three equally sized periods of 6 months within the study period from 1 January 2010 to 30 June 2011.

RESULTS

We found that none of the differences between intervention and control groups were statistically significant.

CONCLUSIONS

Providing GPs with access to a CDSS to aid their decision to use the PSA, had no measurable effect on the GPs' PSA testing behaviour.

摘要

背景

观察等待是前列腺癌（PC）患者治疗的重要组成部分。通过这一策略可实现更有效的疾病管理。正确使用前列腺特异性抗原（PSA）检测至关重要，因此全科医生（GP）可能会受益于一个专注于这一挑战的临床决策支持系统（CDSS）。使用CDSS存在许多障碍。本文的目的是研究通过让全科医生在其电子病历系统（EMR）中通过超链接更便捷地访问基于网络的CDSS，是否可以克服这些障碍。

方法

在这项基于人群的观察性登记研究中，我们设立了干预组和对照组，创建了一个基于网络的CDSS，通过插入到EMR病历内容中的超链接，让全科医生可以访问。干预措施于2011年1月1日引入。我们的结果指标是在2010年1月1日至2011年6月30日的研究期间，按每6个月等长的三个时间段计算，每个诊所每1000名男性的年龄标准化PSA检测率。