测试一种个体化数字决策辅助系统，用于诊断和管理儿童和青少年的精神和行为障碍。
Testing an individualized digital decision assist system for the diagnosis and management of mental and behavior disorders in children and adolescents.
机构信息
Regional Center for Child and Youth Mental Health and Child Welfare (RKBU)- Central Norway, IPH, Faculty of Medicine and Health Sciences, The Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Division of Child and Adolescent Psychiatry, Department of Psychiatry, The University of California San Francisco (UCSF), San Francisco, California, USA.
出版信息
BMC Med Inform Decis Mak. 2020 Sep 17;20(1):232. doi: 10.1186/s12911-020-01239-2.
BACKGROUND
Nearly half of all mental health disorders develop prior to the age of 15. Early assessments, diagnosis, and treatment are critical to shortening single episodes of care, reducing possible comorbidity and long-term disability. In Norway, approximately 20% of all children and adolescents are experiencing mental health problems. To address this, health officials in Norway have called for the integration of innovative approaches. A clinical decision support system (CDSS) is an innovative, computer-based program that provides health professionals with clinical decision support as they care for patients. CDSS use standardized clinical guidelines and big data to provide guidance and recommendations to clinicians in real-time. IDDEAS (Individualised Digital DEcision Assist System) is a CDSS for diagnosis and treatment of child and adolescent mental health disorders. The aim of IDDEAS is to enhance quality, competency, and efficiency in child and adolescent mental health services (CAMHS).
METHODS/DESIGN: IDDEAS is a mixed-methods innovation and research project, which consists of four stages: 1) Assessment of Needs and Preparation of IDDEAS; 2) The Development of IDDEAS CDSS Model; 3) The Evaluation of the IDDEAS CDSS; and, 4) Implementation & Dissemination. Both qualitative and quantitative methods will be used for the evaluation of IDDEAS CDSS model. Child and adolescent psychologists and psychiatrists (n = 30) will evaluate the IDDEAS` usability, acceptability and relevance for diagnosis and treatment of attention-deficit/hyperactivity disorder.
DISCUSSION
The IDDEAS CDSS model is the first guidelines and data-driven CDSS to improve efficiency of diagnosis and treatment of child and adolescent mental health disorders in Norway. Ultimately, IDDEAS will help to improve patient health outcomes and prevent long-term adverse outcomes by providing each patient with evidence-based, customized clinical care.
TRIAL REGISTRATION
ISRCTN, ISRCTN12094788. Ongoing study, registered prospectively 8 April 2020 https://doi.org/10.1186/ISRCTN12094788.
背景
近一半的精神健康障碍在 15 岁之前出现。早期评估、诊断和治疗对于缩短单次护理时间、减少可能的共病和长期残疾至关重要。在挪威，大约 20%的儿童和青少年都存在精神健康问题。为了解决这个问题，挪威卫生官员呼吁采用创新方法。临床决策支持系统 (CDSS) 是一种创新的基于计算机的程序，为医疗保健专业人员在照顾患者时提供临床决策支持。CDSS 使用标准化的临床指南和大数据实时为临床医生提供指导和建议。IDDEAS（个体化数字决策辅助系统）是一种用于诊断和治疗儿童和青少年精神健康障碍的 CDSS。IDDEAS 的目标是提高儿童和青少年精神健康服务 (CAMHS) 的质量、能力和效率。
方法/设计：IDDEAS 是一个混合方法的创新和研究项目，由四个阶段组成：1）需求评估和 IDDEAS 准备；2）IDDEAS CDSS 模型的开发；3）IDDEAS CDSS 的评估；和 4）实施和传播。将使用定性和定量方法来评估 IDDEAS CDSS 模型。儿童和青少年心理学家和精神科医生（n=30）将评估 IDDEAS 的可用性、可接受性以及对注意力缺陷/多动障碍的诊断和治疗的相关性。
讨论
IDDEAS CDSS 模型是首个用于提高挪威儿童和青少年精神健康障碍诊断和治疗效率的指南和数据驱动型 CDSS。最终，IDDEAS 将通过为每位患者提供基于证据的个性化临床护理，帮助改善患者的健康结果并预防长期不良后果。
试验注册
ISRCTN，ISRCTN12094788。正在进行的研究，于 2020 年 4 月 8 日前瞻性注册 https://doi.org/10.1186/ISRCTN12094788。
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