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一种提高急性淋巴细胞白血病患儿化疗方案依从性的临床决策支持系统

A Clinical Decision Support System for Increasing Compliance with Protocols in Chemotherapy of Children with Acute Lymphoblastic Leukemia.

作者信息

Moghaddasi Hamid, Rahimi Rezvan, Kazemi Alireza, Arjmandi Rafsanjani Khadijeh, Bahoush Gholamreza, Rahimi Forough

机构信息

Department of Health Information Management and Technology, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Medical Informatics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

出版信息

Cancer Inform. 2022 Mar 22;21:11769351221084812. doi: 10.1177/11769351221084812. eCollection 2022.

Abstract

OBJECTIVE

In this survey, a protocol-based Chemotherapy Prescription Decision Support System (CPDSS) was designed and evaluated to reduce medication errors in the chemotherapy process of children with ALL.

METHODS

The CPDSS algorithm was extracted by the software development team based on the protocol used by doctors to treat children with ALL. The ASP.Net MVC and SQL Server 2016 programming languages were used to develop the system. A 3-step evaluation (technical, retrospective, and user satisfaction) was performed on CPDSS designed at 2 children's hospitals in Tehran. The data were analyzed using descriptive statistics. At the technical evaluation step, users provided recommendations included in the system.

RESULTS

In the retrospective CPDSS evaluation step, 1281 prescribed doses of the drugs related to 30 patients were entered into the system. CPDSS detected 735 cases of protocol deviations and 57 (95%, CI = 1.25-2.55) errors in prescribed chemotherapy for children with ALL. In the user satisfaction evaluation, the users approved two dimensions of the user interface and functionality of the system.

CONCLUSIONS

With the provision of alerts, the CPDSS can help increase compliance with chemotherapy protocols and decrease the chemotherapy prescribing errors that can improve patient safety.

摘要

目的

在本次调查中,设计并评估了一种基于方案的化疗处方决策支持系统(CPDSS),以减少急性淋巴细胞白血病(ALL)患儿化疗过程中的用药错误。

方法

软件开发团队根据医生治疗ALL患儿所使用的方案提取CPDSS算法。使用ASP.Net MVC和SQL Server 2016编程语言开发该系统。对德黑兰两家儿童医院设计的CPDSS进行了三步评估(技术、回顾性和用户满意度)。使用描述性统计方法分析数据。在技术评估步骤中,用户提供了系统中包含的建议。

结果

在回顾性CPDSS评估步骤中,将与30例患者相关的1281剂处方药录入系统。CPDSS在ALL患儿的化疗处方中检测到735例方案偏差和57例(95%,CI = 1.25 - 2.55)错误。在用户满意度评估中,用户认可系统的用户界面和功能这两个维度。

结论

通过提供警报,CPDSS有助于提高对化疗方案的依从性,并减少化疗处方错误,从而提高患者安全性。

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Prescription order risk factors for pediatric dosing alerts.儿科给药警报的处方医嘱风险因素。
Int J Med Inform. 2015 Feb;84(2):134-40. doi: 10.1016/j.ijmedinf.2014.11.005. Epub 2014 Nov 18.

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