ITMO University, 4 Birzhevaya Liniya, Saint-Petersburg, Russia.
BMC Med Inform Decis Mak. 2022 Mar 27;22(1):79. doi: 10.1186/s12911-022-01805-w.
One of the current major factors of not following up on the abnormal test results is the lack of information about the test results and missing interpretations. Clinical decision support systems (CDSS) can become a solution to this problem. However, little is known how patients react to the automatically generated interpretations of the test results, and how this can affect a decision to follow up. In this research, we study how patients perceive the interpretations of the laboratory tests automatically generated by a clinical decision support system depending on how they receive these recommendations and how this affects the follow-up rate.
A study of 3200 patients was done querying the regional patient registry. The patients were divided into 4 groups who received: 1. Recommendations automatically generated by a CDSS with a clear indication of their automatic nature. 2. Recommendations received personally from a doctor with a clear indication of their automatic nature. 3. Recommendations from a doctor with no indication of their automated generation. 4. No recommendations, only the test results. A follow-up rate was calculated as the proportion of patients referred to a laboratory service for a follow-up investigation after receiving a recommendation within two weeks after the first test with abnormal test results had been completed and the interpretation was delivered to the patient. The second phase of the study was a research of the patients' motivation. It was performed with a group of 789 patients.
All the patients who received interpretations on the abnormal test results demonstrated a significantly higher rate of follow-up (71%) in comparison to the patients who received only test results without interpretations (49%). Patients mention a time factor as a significant benefit of the automatically generated interpretations in comparison to the interpretations they can receive from a doctor.
The results of the study show that delivering automatically generated interpretations of test results can support patients in making a decision to follow up. They are trusted by patients and raise their motivations and engagement.
目前不跟进异常检验结果的一个主要因素是缺乏有关检验结果的信息和缺失的解释。临床决策支持系统（CDSS）可以成为解决此问题的一种方法。然而，对于患者对自动生成的检验结果解释的反应方式以及这如何影响后续决策，人们知之甚少。在这项研究中，我们研究了患者如何根据收到这些建议的方式以及这如何影响后续率，来感知由临床决策支持系统自动生成的实验室检验结果的解释。
通过查询区域患者登记处，对 3200 名患者进行了一项研究。患者被分为 4 组，分别接受以下处理：1. 由 CDSS 自动生成的建议，并明确指出其自动生成的性质。2. 由医生亲自提供的建议，并明确指出其自动生成的性质。3. 来自医生的建议，但没有指示其自动生成。4. 没有建议，只有检验结果。在完成第一次异常检验并将解释传递给患者后两周内，根据收到建议后患者是否被转介到实验室服务进行随访调查，计算随访率。研究的第二阶段是对患者动机的研究。该阶段在 789 名患者中进行。
与仅收到异常检验结果但没有解释的患者（49%）相比，所有收到异常检验结果解释的患者都表现出明显更高的后续率（71%）。与他们可以从医生那里获得的解释相比，患者提到自动生成的解释作为时间因素的显著优势。
研究结果表明，提供自动生成的检验结果解释可以帮助患者做出后续决策。患者信任这些解释，并提高了他们的积极性和参与度。
