Séroussi Brigitte, Soulet Arnaud, Spano Jean-Philippe, Lefranc Jean-Pierre, Cojean-Zelek Isabelle, Blaszka-Jaulerry Brigitte, Zelek Laurent, Durieux Axel, Tournigand Christophe, Messai Nizar, Rousseau Alexandra, Bouaud Jacques
UPMC, UFR de Médecine, Sorbonne Universités, Paris, France.
Stud Health Technol Inform. 2013;192:534-8.
OncoDoc2 is a guideline-based clinical decision support system (CDSS) for breast cancer management. It has been used as an intervention in a randomized controlled trial carried out to evaluate the impact of using a CDSS upon the compliance with clinical practice guidelines (CPGs) of multidisciplinary staff meeting decisions. Data mining was used to discover multi-criteria regularities as "emerging patterns" (EPs) associated with compliance and non-compliance with CPGs when using and not using OncoDoc2 and to assess which patients may benefit from the use of the CDSS. Decision data was collected from all participating centers. The number of EPs associated with non-compliance is smaller in the intervention arm, which suggests a practice harmonization effect of OncoDoc2. EPs associated with compliant decisions in both arms of the trial correspond to situations well identified in CPGs. EPs associated with non-compliant decisions when the system is not used are associated with compliance when the system is used except in clinical situations where evidence is lacking.
OncoDoc2是一个基于指南的乳腺癌管理临床决策支持系统（CDSS）。它已被用作一项随机对照试验的干预措施，该试验旨在评估使用CDSS对多学科工作人员会议决策遵循临床实践指南（CPG）的影响。数据挖掘用于发现与使用和不使用OncoDoc2时遵循和不遵循CPG相关的多标准规律，即“新兴模式”（EP），并评估哪些患者可能从使用CDSS中受益。决策数据从所有参与中心收集。干预组中与不遵循相关的EP数量较少，这表明OncoDoc2具有实践协调效果。试验两组中与合规决策相关的EP对应于CPG中明确识别的情况。当系统未使用时与不合规决策相关的EP，在系统使用时与合规相关，但在缺乏证据的临床情况下除外。
