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DESIREE,一个用于管理原发性乳腺癌患者的决策支持平台的初步定性和定量评估。

Preliminary Qualitative and Quantitative Evaluation of DESIREE, a Decision Support Platform for the Management of Primary Breast Cancer Patients.

机构信息

Univ. Lille, Inserm, CHU Lille, CIC-IT 1403/Evalab, EA 2694, Lille, France.

Assistance Publique-Hôpitaux de Paris, DRCI, Paris, France.

出版信息

AMIA Annu Symp Proc. 2021 Jan 25;2020:1012-1021. eCollection 2020.

Abstract

The DESIREE project has developed a platform offering several complementary therapeutic decision support systems (DSSs) to improve care quality for breast cancer patients. A first assessment of the system was carried out in close-to-real tumor boards (TBs). Fourteen TB sessions were organized corresponding to a total of 125 exploitable decisions previously made without the system and re-played with the system after a washout period in three pilot sites. Results show an overestimation of declared compliance with guidelines when not using the system as compared to measured compliance with the recommendations issued from the guideline-based DSS of DESIREE. After using the system, measured compliance rate of decisions with guidelines was significantly improved from 74.4% to 89.6%. Most of the changes in decisions when using the guideline-based DSS were associated with non-compliant decisions that became compliant. Qualitative analysis and interviews showed that despite maturity issues, clinicians found DESIREE DSSs innovative and promising.

摘要

DESIREE 项目开发了一个平台,提供了几个互补的治疗决策支持系统(DSS),以提高乳腺癌患者的护理质量。对系统进行了首次评估,是在接近真实的肿瘤委员会(TB)中进行的。组织了 14 次 TB 会议,共涉及 125 项可利用的决策,这些决策是在三个试点地点使用系统之前和使用系统后的洗脱期内做出的。结果表明,与基于指南的 DESIREE DSS 发布的建议的测量依从性相比,在不使用系统时,对指南的声明依从性存在高估。使用系统后,与指南一致的决策的测量依从率从 74.4%显著提高到 89.6%。使用基于指南的 DSS 时,决策的大多数变化都与变得一致的不一致决策有关。定性分析和访谈表明,尽管存在成熟度问题,但临床医生认为 DESIREE DSS 具有创新性和前景。

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