Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Computer Engineering, Mashhad Branch, Islamic Azad University, Mashhad, Iran.
J Med Syst. 2017 Dec 23;42(2):26. doi: 10.1007/s10916-017-0881-6.
To evaluate the effect of a computerized Decision Support System (CDSS) on improving adherence to an anticoagulation guideline for the treatment of atrial fibrillation (AF). This study had an interrupted time series design. The adherence to the guideline was assessed at fortnightly (two weeks) intervals from January 2016 to January 2017, 6 months before and 6 months after intervention. Newly diagnosed patients with AF were included in the offices of ten cardiologists. Stroke and major bleeding risks were calculated by the CDSS which was implemented via a mobile application. Treatment recommendations based on the guideline were shown to cardiologists. The segmented regression model was used to evaluate the effect of CDSS on level and trend of guideline adherence for the treatment of AF. In our analysis, 373 patients were included. The trend of adherence to the anticoagulation guideline for the treatment of AF was stable in the pre-intervention phase. After the CDSS intervention, mean of the adherence to the guideline significantly increased from 48% to 65.5% (P-value < 0.0001). The trend of adherence to the guideline was stable in the post-intervention phase. Our results showed that the CDSS can improve adherence to the anticoagulation guideline for the treatment of AF. Registration ID: IRCT2016052528070N1.
评估计算机决策支持系统 (CDSS) 对改善心房颤动 (AF) 抗凝治疗指南依从性的效果。本研究采用了中断时间序列设计。在干预前 6 个月（2016 年 1 月至 2017 年 1 月）和干预后 6 个月，每隔两周（两周）评估一次对指南的依从性。将新诊断为 AF 的患者纳入十名心脏病专家的办公室。CDSS 通过移动应用程序进行实施，计算中风和大出血风险。根据指南向心脏病专家展示治疗建议。使用分段回归模型评估 CDSS 对 AF 治疗指南依从性水平和趋势的影响。在我们的分析中，纳入了 373 名患者。AF 抗凝治疗指南依从性的趋势在干预前阶段保持稳定。在 CDSS 干预后，指南的依从性平均值从 48%显著增加到 65.5%（P 值 < 0.0001）。干预后阶段的依从性趋势保持稳定。我们的结果表明，CDSS 可以提高 AF 抗凝治疗指南的依从性。注册号：IRCT2016052528070N1。
