医生之间关于药物相互作用临床意义的评分者间一致性。
Inter-rater agreement among physicians on the clinical significance of drug-drug interactions.
作者信息
Strasberg Howard R, Chan Albert, Sklar Stephen J
机构信息
Wolters Kluwer Health, Indianapolis, IN.
Palo Alto Medical Foundation, Palo Alto, CA.
出版信息
AMIA Annu Symp Proc. 2013 Nov 16;2013:1325-8. eCollection 2013.
BACKGROUND
Alert fatigue could potentially be improved if physicians agreed on which alerts were clinically significant. We conducted a study to determine the extent to which physicians agree on which drug-drug interactions are clinically significant.
METHODS
Two groups of eight generalist physicians reviewed 100 randomly selected drug-drug interactions from the Medi-Span® Drug Therapy Monitoring System™ database and indicated whether they thought each interaction was clinically significant based on the full-text clinical discussion contained within each interaction monograph and their clinical experience.
RESULTS
The Fleiss Kappa measure of inter-rater agreement was 0.19 (0.12, 0.26) for one group, 0.22 (0.14, 0.29) for the second group and 0.21 (0.15, 0.27) for the combined group.
CONCLUSION
We found poor agreement among generalist physicians on which drug-drug interactions are clinically significant. Use of a feature to allow physicians to tailor alerts to their needs may be an important component in reducing alert fatigue.
背景
如果医生们就哪些警报具有临床意义达成共识，那么警报疲劳可能会得到改善。我们开展了一项研究，以确定医生们在哪些药物相互作用具有临床意义这一问题上的共识程度。
方法
两组各有八名全科医生，他们从Medi-Span®药物治疗监测系统™数据库中随机抽取100种药物相互作用进行审查，并根据每种相互作用专论中包含的全文临床讨论以及他们的临床经验，指出他们是否认为每种相互作用具有临床意义。
结果
一组的评分者间一致性的Fleiss Kappa测量值为0.19（0.12，0.26），第二组为0.22（0.14，0.29），合并组为0.21（0.15，0.27）。
结论
我们发现全科医生在哪些药物相互作用具有临床意义这一问题上的共识较差。使用一种功能让医生能够根据自身需求定制警报，可能是减少警报疲劳的一个重要组成部分。
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