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成人及儿科重症监护中的计算机化决策支持

Computerized decision support in adult and pediatric critical care.

作者信息

Williams Cydni N, Bratton Susan L, Hirshberg Eliotte L

机构信息

Cydni N Williams, Susan L Bratton, Eliotte L Hirshberg, Department of Pediatrics, University of Utah, Pediatric Critical Care, Salt Lake City, UT 84158, United States.

出版信息

World J Crit Care Med. 2013 Nov 4;2(4):21-8. doi: 10.5492/wjccm.v2.i4.21.

Abstract

Computerized decision support (CDS) is the most advanced form of clinical decision support available and has evolved with innovative technologies to provide meaningful assistance to medical professionals. Critical care clinicians are in unique environments where vast amounts of data are collected on individual patients, and where expedient and accurate decisions are paramount to the delivery of quality healthcare. Many CDS tools are in use today among adult and pediatric intensive care units as diagnostic aides, safety alerts, computerized protocols, and automated recommendations for management. Some CDS use have significantly decreased adverse events and improved costs when carefully implemented and properly operated. CDS tools integrated into electronic health records are also valuable to researchers providing rapid identification of eligible patients, streamlining data-gathering and analysis, and providing cohorts for study of rare and chronic diseases through data-warehousing. Although the need for human judgment in the daily care of critically ill patients has limited the study and realization of meaningful improvements in overall patient outcomes, CDS tools continue to evolve and integrate into the daily workflow of clinicians, and will likely provide advancements over time. Through novel technologies, CDS tools have vast potential for progression and will significantly impact the field of critical care and clinical research in the future.

摘要

计算机化决策支持(CDS)是现有的最先进的临床决策支持形式,并且随着创新技术不断发展,为医学专业人员提供有意义的帮助。重症监护临床医生所处的环境独特,在此环境中会收集大量关于个体患者的数据,而且迅速且准确的决策对于提供高质量医疗保健至关重要。如今,许多CDS工具在成人和儿科重症监护病房中作为诊断辅助工具、安全警报、计算机化协议以及管理的自动化建议使用。当谨慎实施并正确操作时,一些CDS的使用显著减少了不良事件并降低了成本。集成到电子健康记录中的CDS工具对于研究人员也很有价值,可快速识别符合条件的患者、简化数据收集和分析,并通过数据仓库提供用于罕见病和慢性病研究的队列。尽管在重症患者的日常护理中对人类判断的需求限制了对整体患者结局有意义改善的研究和实现,但CDS工具仍在不断发展并融入临床医生的日常工作流程,并且随着时间的推移可能会带来进步。通过新技术,CDS工具具有巨大的发展潜力,未来将对重症监护和临床研究领域产生重大影响。

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