循证健康信息学:推广该原则的十年努力。IMIA评估工作组和EFMI评估工作组的共同贡献。
Evidence Based Health Informatics: 10 Years of Efforts to Promote the Principle. Joint Contribution of IMIA WG EVAL and EFMI WG EVAL.
作者信息
Rigby M, Ammenwerth E, Beuscart-Zephir M-C, Brender J, Hyppönen H, Melia S, Nykänen P, Talmon J, de Keizer N
机构信息
Lavender Hill, 6 Carrighill Lower, Calverstown, Kilcullen, Co. Kildare, Ireland. E-mail:
出版信息
Yearb Med Inform. 2013;8:34-46.
OBJECTIVES
To present the importance of Evidence-based Health Informatics (EBHI) and the ethical imperative of this approach; to highlight the work of the IMIA Working Group on Technology Assessment and Quality Improvement and the EFMI Working Group on Assessment of Health Information Systems; and to introduce the further important evaluation and evidence aspects being addressed.
METHODS
Reviews of IMIA, EFMA and other initiatives, together with literature reviews on evaluation methods and on published systematic reviews.
RESULTS
Presentation of the rationale for the health informatics domain to adopt a scientific approach by assessing impact, avoiding harm, and empirically demonstrating benefit and best use; reporting of the origins and rationale of the IMIA- and EQUATOR-endorsed Statement on Reporting of Evaluation Studies in Health Informatics (STARE-HI) and of the IMIA WG's Guideline for Good Evaluation Practice in Health Informatics (GEP-HI); presentation of other initiatives for objective evaluation; and outlining of further work in hand on usability and indicators; together with the case for development of relevant evaluation methods in newer applications such as telemedicine. The focus is on scientific evaluation as a reliable source of evidence, and on structured presentation of results to enable easy retrieval of evidence.
CONCLUSIONS
EBHI is feasible, necessary for efficiency and safety, and ethically essential. Given the significant impact of health informatics on health systems, care delivery and personal health, it is vital that cultures change to insist on evidence-based policies and investment, and that emergent global moves for this are supported.
目的
阐述循证健康信息学(EBHI)的重要性及其方法的伦理必要性;强调国际医学信息学协会(IMIA)技术评估与质量改进工作组以及欧洲医学信息学学会(EFMI)健康信息系统评估工作组的工作;介绍正在探讨的其他重要评估及证据方面的内容。
方法
对IMIA、EFMA及其他倡议进行综述,并对评估方法及已发表的系统综述进行文献综述。
结果
阐述健康信息学领域采用科学方法的基本原理,即评估影响、避免危害并通过实证证明益处及最佳应用方式;报告IMIA与《健康信息学评估研究报告规范》(STARE-HI)认可的声明以及IMIA工作组《健康信息学良好评估实践指南》(GEP-HI)的起源和基本原理;介绍其他客观评估倡议;概述在可用性和指标方面正在开展的进一步工作;以及在远程医疗等新应用中开发相关评估方法的必要性。重点在于将科学评估作为可靠的证据来源,并以结构化方式呈现结果以便于证据检索。
结论
EBHI是可行的,对效率和安全至关重要,且在伦理上必不可少。鉴于健康信息学对卫生系统、医疗服务提供和个人健康具有重大影响,至关重要的是转变观念,坚持基于证据的政策和投资,并支持为此而出现的全球行动。