Spratt Kevin F
Department of Orthopaedics, One Medical Center Drive, HB 7999, Geisel School of Medicine at Dartmouth, Hanover, NH 03756.
Mil Med. 2013 Oct;178(10 Suppl):121-31. doi: 10.7205/MILMED-D-13-00257.
The primary aim of this review was to compare and contrast the principles of the Assessment-Diagnosis-Treatment-Outcomes (ADTO) model with clinical prediction rules, shared decision making, and practice guidelines and provide a framework for validating medical simulations.
Comparing and contrasting the various methods and tools used by the clinical community and patients to help make informed decisions regarding health care options.
The ADTO model provides an excellent theoretical framework to analyze and conceptualize the interrelationships between clinicians and patients as they go through the process of determining best practices. However, the ADTO model may be too comprehensive to implement within any given clinical prediction rule or hypothetical-construct-oriented medical simulation, at least at this point in the development of these fields.
The way forward for developing substantive medical simulations that will tie together complex constructs is to start at the beginning and plan to make small steps as a basis for establishing the infrastructure that will lead to a giant leap for mankind.
本综述的主要目的是比较和对比评估-诊断-治疗-结果（ADTO）模型与临床预测规则、共同决策和实践指南的原则，并为验证医学模拟提供一个框架。
比较和对比临床社区和患者用于就医疗保健选择做出明智决策的各种方法和工具。
ADTO模型提供了一个出色的理论框架，用于分析和概念化临床医生和患者在确定最佳实践过程中的相互关系。然而，ADTO模型可能过于全面，以至于至少在这些领域发展的现阶段，难以在任何给定的临床预测规则或面向假设构建的医学模拟中实施。
开发能够将复杂结构联系在一起的实质性医学模拟的前进方向是从一开始就着手，并计划迈出小步伐，作为建立基础设施的基础，这将为人类带来巨大飞跃。
