Likhterov Ilya, Tuttle R Michael, Haser Grace C, Su Henry K, Bergman Donald, Alon Eran E, Bernet Victor, Brett Elise, Cobin Rhoda, Dewey Eliza H, Doherty Gerard, Dos Reis Laura L, Klopper Joshua, Lee Stephanie L, Lupo Mark A, Machac Josef, Mechanick Jeffrey I, Milas Mira, Orloff Lisa, Randolph Gregory, Ross Douglas S, Rowe Meghan E, Smallridge Robert, Terris David, Tufano Ralph P, Urken Mark L
Department of Otolaryngology - Head and Neck Surgery, Mount Sinai Beth Israel, New York, New York.
Memorial Sloan Kettering Cancer Center, New York, New York.
Laryngoscope. 2016 Nov;126(11):2640-2645. doi: 10.1002/lary.25986. Epub 2016 Apr 14.
OBJECTIVES/HYPOTHESIS: To present an overview of the barriers to the implementation of clinical practice guidelines (CPGs) in thyroid cancer management and to introduce a computer-based clinical support system.
PubMed.
A review of studies on adherence to CPGs was conducted.
Awareness and adoption of CPGs is low in thyroid cancer management. Barriers to implementation include unfamiliarity with the CPGs and financial concerns. Effective interventions to improve adherence are possible, especially when they are readily accessible at the point of care delivery. Computerized clinical support systems show particular promise. The authors introduce the clinical decision making modules (CDMMs) of the Thyroid Cancer Care Collaborative, a thyroid cancer-specific electronic health record. These computer-based modules can assist clinicians with implementation of these recommendations in clinical practice.
Computer-based support systems can help clinicians understand and adopt the thyroid cancer CPGs. By integrating patient characteristics and guidelines at the point of care delivery, the CDMMs can improve adherence to the guidelines and help clinicians provide high-quality, evidence-based, and individualized patient care in the management of differentiated thyroid cancer. Laryngoscope, 126:2640-2645, 2016.
目的/假设：概述甲状腺癌管理中临床实践指南（CPG）实施的障碍，并介绍一种基于计算机的临床支持系统。
PubMed。
对关于CPG依从性的研究进行综述。
在甲状腺癌管理中，CPG的知晓率和采用率较低。实施障碍包括对CPG不熟悉和财务问题。改善依从性的有效干预措施是可行的，尤其是在医疗服务点易于获取时。计算机化临床支持系统显示出特别的前景。作者介绍了甲状腺癌护理协作组织的临床决策模块（CDMM），这是一种针对甲状腺癌的电子健康记录。这些基于计算机的模块可以帮助临床医生在临床实践中实施这些建议。
基于计算机的支持系统可以帮助临床医生理解并采用甲状腺癌CPG。通过在医疗服务点整合患者特征和指南，CDMM可以提高对指南的依从性，并帮助临床医生在分化型甲状腺癌管理中提供高质量、基于证据且个性化的患者护理。《喉镜》，126:2640 - 2645，2016年。
