临床决策支持用于成人和儿科高血压的诊断和管理。
Clinical Decision Support for the Diagnosis and Management of Adult and Pediatric Hypertension.
机构信息
Department of Medicine, University of Texas Southwestern (UTSW) Medical School, Dallas, TX, USA.
Departments of Pediatrics and Medicine, UTSW and Children's Health, 5323 Harry Hines Blvd., Dallas, TX, 75390-9063, USA.
出版信息
Curr Hypertens Rep. 2020 Aug 27;22(9):67. doi: 10.1007/s11906-020-01083-9.
PURPOSE OF REVIEW
To review literature from 2016 to 2019 on clinical decision support (CDS) for diagnosis and management of hypertension in children and adults.
RECENT FINDINGS
Ten studies described hypertension CDS systems. Novel advances included the integration of patient-collected blood pressure data, automated information retrieval and management support, and use of CDS in low-resource/developing-world settings and in pediatrics. Findings suggest that CDS increases hypertension detection/control, yet many children and adults with hypertension remain undetected or undercontrolled. CDS challenges included poor usability (from lack of health record integration, excessive data entry requests, and wireless connectivity challenges) and lack of clinician trust in blood pressure measures. Hypertension CDS has improved but not closed gaps in the detection and control of hypertension in children and adults. The studies reviewed indicate that the usability of CDS and the system where CDS is deployed (e.g., commitment to high-quality blood pressure measurement/infrastructure) may impact CDS's ability to increase hypertension detection and control.
目的综述
回顾 2016 年至 2019 年有关儿童和成人高血压诊断和管理的临床决策支持（CDS）的文献。
最新发现
有 10 项研究描述了高血压 CDS 系统。新的进展包括整合患者采集的血压数据、自动信息检索和管理支持，以及在资源匮乏/发展中世界环境和儿科中使用 CDS。研究结果表明，CDS 增加了高血压的检出/控制率，但仍有许多儿童和成人的高血压未被检出或控制不佳。CDS 面临的挑战包括可用性差（由于缺乏健康记录整合、过多的数据输入请求以及无线连接挑战）以及临床医生对血压测量的不信任。高血压 CDS 虽改善了儿童和成人高血压的检出和控制方面的差距，但并未完全消除。综述中的研究表明，CDS 的可用性以及部署 CDS 的系统（例如，对高质量血压测量/基础设施的承诺）可能会影响 CDS 提高高血压检出和控制的能力。
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