School of Allied Health Professions, Keele University, Keele, UK.
School of Pharmacy and Bioengineering, Keele University, Keele, UK.
BMC Med Inform Decis Mak. 2021 Feb 27;21(1):78. doi: 10.1186/s12911-021-01446-5.
Currently the diagnosis of shoulder instability, particularly in children, is difficult and can take time. These diagnostic delays can lead to poorer outcome and long-term complications. A Diagnostic Decision Support System (DDSS) has the potential to reduce time to diagnosis and improve outcomes for patients. The aim of this study was to develop a concept map for a future DDSS in shoulder instability.
A modified nominal focus group technique, involving three clinical vignettes, was used to elicit physiotherapists decision-making processes.
Twenty-five physiotherapists, (18F:7 M) from four separate clinical sites participated. The themes identified related to 'Variability in diagnostic processes and lack of standardised practice' and 'Knowledge and attitudes towards novel technologies for facilitating assessment and clinical decision making'.
No common structured approach towards assessment and diagnosis was identified. Lack of knowledge, perceived usefulness, access and cost were identified as barriers to adoption of new technology. Based on the information elicited a conceptual design of a future DDSS has been proposed. Work to develop a systematic approach to assessment, classification and diagnosis is now proposed. Trial Registraty This was not a clinical trial and so no clinical trial registry is needed.
目前，肩不稳定的诊断，特别是在儿童中，较为困难且耗时。这些诊断延迟可能导致较差的结果和长期并发症。诊断决策支持系统（DDSS）有可能缩短诊断时间并改善患者的预后。本研究旨在为肩不稳定的未来 DDSS 制定概念图。
采用改良的名义焦点小组技术，结合三个临床案例，引出物理治疗师的决策过程。
来自四个不同临床地点的 25 名物理治疗师（18 名女性：7 名男性）参与了研究。确定的主题涉及“诊断过程的可变性和缺乏标准化实践”和“对促进评估和临床决策的新技术的知识和态度”。
未确定评估和诊断的通用结构化方法。缺乏知识、感知有用性、可及性和成本被认为是采用新技术的障碍。根据所获得的信息，提出了未来 DDSS 的概念设计。目前拟开展工作以制定评估、分类和诊断的系统方法。试验注册本研究不是临床试验，因此不需要临床试验注册。
