Vuokko Riikka, Vakkuri Anne, Palojoki Sari
Department of Steering of Health Care and Social Welfare, Ministry of Social Affairs and Health, Helsinki, Finland.
Department of Anesthesiology, Intensive Care and Pain Medicine, Peijas Hospital, Helsinki University Hospital, Vantaa, Finland.
JMIR Form Res. 2022 Mar 29;6(3):e35474. doi: 10.2196/35474.
Currently, there is no holistic theoretical approach available for guiding classification development. On the basis of our recent classification development research in the area of patient safety in health information technology, this focus area would benefit from a more systematic approach. Although some valuable theoretical and methodological approaches have been presented, classification development literature typically is limited to methodological development in a specific domain or is practically oriented.
The main purposes of this study are to fill the methodological gap in classification development research by exploring possible elements of systematic development based on previous literature and to promote sustainable and well-grounded classification outcomes by identifying a set of recommended elements. Specifically, the aim is to answer the following question: what are the main elements for systematic classification development based on research evidence and our use case?
This study applied a qualitative research approach. On the basis of previous literature, preliminary elements for classification development were specified, as follows: defining a concept model, documenting the development process, incorporating multidisciplinary expertise, validating results, and maintaining the classification. The elements were compiled as guiding principles for the research process and tested in the case of patient safety incidents (n=501).
The results illustrate classification development based on the chosen elements, with 4 examples of technology-induced errors. Examples from the use case regard usability, system downtime, clinical workflow, and medication section problems. The study results confirm and thus suggest that a more comprehensive and theory-based systematic approach promotes well-grounded classification work by enhancing transparency and possibilities for assessing the development process.
We recommend further testing the preliminary main elements presented in this study. The research presented herein could serve as a basis for future work. Our recently developed classification and the use case presented here serve as examples. Data retrieved from, for example, other type of electronic health records and use contexts could refine and validate the suggested methodological approach.
目前，尚无全面的理论方法可用于指导分类体系的开发。基于我们近期在健康信息技术患者安全领域的分类体系开发研究，这一重点领域将受益于更系统的方法。尽管已经提出了一些有价值的理论和方法，但分类体系开发文献通常局限于特定领域的方法开发，或是以实践为导向。
本研究的主要目的是通过基于以往文献探索系统开发的可能要素，填补分类体系开发研究中的方法空白，并通过确定一组推荐要素来促进可持续且有充分依据的分类结果。具体而言，目标是回答以下问题：基于研究证据和我们的用例，系统分类体系开发的主要要素有哪些？
本研究采用定性研究方法。基于以往文献，确定了分类体系开发的初步要素，如下：定义概念模型、记录开发过程、纳入多学科专业知识、验证结果以及维护分类体系。这些要素被编制为研究过程的指导原则，并在患者安全事件（n = 501）案例中进行了测试。
结果展示了基于所选要素的分类体系开发，有4个技术引发错误的示例。用例中的示例涉及可用性、系统停机时间、临床工作流程和用药环节问题。研究结果证实并表明，更全面且基于理论的系统方法通过提高透明度和评估开发过程的可能性，促进了有充分依据的分类工作。
我们建议进一步测试本研究中提出的初步主要要素。本文所呈现的研究可为未来工作提供基础。我们近期开发的分类体系及此处呈现的用例可作为示例。从例如其他类型电子健康记录和使用情境中检索的数据可完善并验证所建议的方法。
