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对实验室检查异常结果进行自动解读后的随访。

Follow-Up on the Abnormal Laboratory Test Results with Automatic Interpretation.

作者信息

Kopanitsa Georgy

机构信息

ITMO University, Saint Petersburg, Russia.

出版信息

Stud Health Technol Inform. 2020 Sep 4;273:240-245. doi: 10.3233/SHTI200647.

DOI:10.3233/SHTI200647
PMID:33087619
Abstract

Failing to follow up on the abnormal test results can cause serious health problems to patients. We conducted a retrospective medical record review of 3200 randomly selected patients aged 18 to 76 in 14 state clinics and two private laboratory services querying the common regional patient registry. One patient could be included (1 clinical case) in the study only once. We invited patients to take part in the interviews to gain a deeper understanding of the motives to follow up or not after receiving a recommendation and explanation of the role of the automatically generated interpretation in this decision. A qualitative study of the patients' motivation was performed with a group of 689 patients. All the patients who received their interpretations showed a much higher follow-up rate (68% average) than the patients who did not receive interpretations (49 % average). The results of our research demonstrated that there is a significant impact on the patients' decision to follow up on the tests. Patients consider time factor as an important advantage of the computer interpretations and are willing to get automatic interpretations if they can receive it faster than the ones from their doctor (question 4: median =3 out of 7). Discussing the reasons behind the decision to follow up, the patients do trust the computerized clinical decision support systems (question 5: median = 5 out of 7), however, they prefer to receive interpretations and recommendations from doctors (question 3: median = 7).

摘要

对异常检查结果不进行跟进可能会给患者带来严重的健康问题。我们对14家州立诊所和两家私人实验室服务机构中随机抽取的3200名年龄在18至76岁之间的患者进行了回顾性病历审查,查询了当地通用的患者登记系统。一名患者在该研究中只能被纳入一次(即1个临床病例)。我们邀请患者参与访谈,以更深入地了解他们在收到关于自动生成的解读在该决策中的作用的建议和解释后,决定是否跟进的动机。我们对689名患者进行了关于患者动机的定性研究。所有收到解读结果的患者的跟进率(平均68%)远高于未收到解读结果的患者(平均49%)。我们的研究结果表明,这对患者跟进检查的决定有重大影响。患者认为时间因素是计算机解读的一个重要优势,如果能比从医生那里更快得到自动解读结果,他们愿意接受(问题4:中位数为7分制中的3分)。在讨论跟进决定背后的原因时,患者确实信任计算机化临床决策支持系统(问题5:中位数为7分制中的5分),然而,他们更愿意从医生那里获得解读和建议(问题3:中位数为7分制中的7分)。

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