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计算指南和临床决策支持在宫颈癌筛查和管理中的应用,以改善结局和健康公平性。

Computable Guidelines and Clinical Decision Support for Cervical Cancer Screening and Management to Improve Outcomes and Health Equity.

机构信息

Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

MITRE Healthcare Federally Funded Research and Development Center, McLean, Virginia, USA.

出版信息

J Womens Health (Larchmt). 2022 Apr;31(4):462-468. doi: 10.1089/jwh.2022.0100.

Abstract

Cervical cancer is highly preventable when precancerous lesions are detected early and appropriately managed. However, the complexity of and frequent updates to existing evidence-based clinical guidelines make it challenging for clinicians to stay abreast of the latest recommendations. In addition, limited availability and accessibility to information technology (IT) decision supports make it difficult for groups who are medically underserved to receive screening or receive the appropriate follow-up care. The Centers for Disease Control and Prevention (CDC), Division of Cancer Prevention and Control (DCPC), is leading a multiyear initiative to develop computer-interpretable ("computable") version of already existing evidence-based guidelines to support clinician awareness and adoption of the most up-to-date cervical cancer screening and management guidelines. DCPC is collaborating with the MITRE Corporation, leading scientists from the National Cancer Institute, and other CDC subject matter experts to translate existing narrative guidelines into computable format and develop clinical decision support tools for integration into health IT systems such as electronic health records with the ultimate goal of improving patient outcomes and decreasing disparities in cervical cancer outcomes among populations that are medically underserved. This initiative meets the challenges and opportunities highlighted by the President's Cancer Panel and the President's Cancer Moonshot 2.0 to nearly eliminate cervical cancer.

摘要

当癌前病变被及早发现并得到适当处理时,宫颈癌是高度可预防的。然而,现有的基于证据的临床指南的复杂性和频繁更新使得临床医生难以跟上最新的建议。此外,信息技术(IT)决策支持的有限可用性和可及性使得医疗服务不足的群体难以接受筛查或获得适当的随访护理。疾病预防控制中心(CDC)癌症预防与控制司(DCPC)正在领导一项多年倡议,以开发现有的基于证据的指南的计算机可解释(“可计算”)版本,以支持临床医生对最新宫颈癌筛查和管理指南的认识和采用。DCPC 正在与米特公司、美国国家癌症研究所的主要科学家以及其他 CDC 主题专家合作,将现有的叙述性指南转化为可计算的格式,并开发临床决策支持工具,以整合到电子健康记录等健康 IT 系统中,最终目标是改善患者的治疗效果,并减少医疗服务不足的人群中宫颈癌治疗效果的差异。这一倡议满足了总统癌症小组和总统癌症登月计划 2.0 的挑战和机遇,以几乎消除宫颈癌。

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