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生命关键共享决策系统的七大关键挑战。

The seven key challenges for life-critical shared decision making systems.

机构信息

Division of Computer Science & Engin, College of Engineering, Louisiana State University, Baton Rouge, LA, 70803, USA; Department of Medicine, Section of Hematology & Med Oncology, School of Medicine, Tulane University, New Orleans, LA, 70112, USA.

Complete Decisions, LLC, Baton Rouge, LA, 70810, USA.

出版信息

Int J Med Inform. 2021 Apr;148:104377. doi: 10.1016/j.ijmedinf.2021.104377. Epub 2021 Jan 9.

Abstract

BACKGROUND

Shared decision making (SDM) for life-critical diseases or conditions is a crucial type of SDM. This type of SDM is still greatly underdeveloped and it faces a number of key challenges. The main goal of this study is to identify the challenges that impede the development and use of life-critical SDM.

METHODS

This is a hybrid research and systematic / narrative review paper. Its results were derived by analyzing reviews already conducted by the authors when they were working on six recently published papers. These papers had collectively required two systematic reviews and four narrative reviews. The topics covered in the six published papers were related to computer-aided diagnosis (CAD) in medicine, the analysis of health state utilities, and the selection of the best treatment for life-critical diseases / conditions. A new narrative review was also executed to explore some new issues.

RESULTS

The key challenges for life-critical SDM relate to the following aspects: The mathematical models used to make the decisions, the data used to feed these models, the role the patient plays within the SDM framework, and finally, the role healthcare professionals play along with the pertinent rules and regulations that guide the use of this type of SDM today.

CONCLUSIONS

Life-critical SDM is the most important type of SDM. However, some challenges impede its successful development and use. A number of developments and enhancements need to be made urgently for this type of SDM to become widely acceptable and useful. The seven key challenges identified in this study and the suggested directions for future research offer a compelling path towards elevating life-critical SDM to the next level and do so both effectively and efficiently.

摘要

背景

危及生命的疾病或状况的共同决策(SDM)是一种至关重要的 SDM 类型。这种类型的 SDM 仍然很不发达,它面临着许多关键挑战。本研究的主要目的是确定阻碍生命关键型 SDM 发展和使用的挑战。

方法

这是一项混合研究和系统/叙述性综述论文。其结果是通过分析作者在撰写六篇最近发表的论文时已经进行的综述得出的。这些论文共同需要进行两项系统评价和四项叙述性评价。已发表的六篇论文涵盖的主题与医学中的计算机辅助诊断 (CAD)、健康状态效用分析以及危及生命的疾病/状况的最佳治疗选择有关。还进行了一项新的叙述性评论,以探索一些新问题。

结果

危及生命的 SDM 的关键挑战涉及以下几个方面:用于做出决策的数学模型、用于为这些模型提供数据、患者在 SDM 框架中的角色,以及医疗保健专业人员的角色以及当前指导使用这种类型的 SDM 的相关规则和法规。

结论

危及生命的 SDM 是最重要的 SDM 类型。然而,一些挑战阻碍了它的成功发展和使用。迫切需要进行一些发展和改进,以使这种类型的 SDM 得到广泛接受和有用。本研究确定的七个关键挑战以及对未来研究的建议方向为提升危及生命的 SDM 到下一个水平提供了一条引人注目的道路,既有效又高效。

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