Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
Department of Internal Medicine, Division of Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
BMC Med Inform Decis Mak. 2022 May 10;22(1):127. doi: 10.1186/s12911-022-01860-3.
To describe and evaluate a clinical decision support system (CDSS) for empirical antibiotic therapy using a systematic framework.
A reporting framework for behavior change intervention implementation was used, which includes several domains: development, evaluation and implementation. Within the development domain a description is given of the engagement of stakeholders, a rationale for how the CDSS may influence antibiotic prescribing and a detailed outline of how the system was developed. Within the evaluation domain a technical validation is performed and the interaction between potential users and the CDSS is analyzed. Within the domain of implementation a description is given on how the CDSS was tested in the real world and the strategies that were used for implementation and adoption of the CDSS.
Development: a CDSS was developed, with the involvement of stakeholders, to assist empirical antibiotic prescribing by physicians.
Technical problems were determined during the validation process and corrected in a new CDSS version. A usability study was performed to assess problems in the system-user interaction.
In 114 patients the antibiotic advice that was generated by the CDSS was followed. For 54 patients the recommendations were not adhered to.
This study describes the development and validation of a CDSS for empirical antibiotic therapy and shows the usefulness of the systematic framework for reporting CDSS interventions. In addition it shows that CDSS recommendations are not always adhered to which is associated with incorrect use of the system.
描述并评估了一种使用系统框架的经验性抗生素治疗临床决策支持系统（CDSS）。
使用行为改变干预实施报告框架，其中包括几个领域：开发、评估和实施。在开发领域中，描述了利益相关者的参与情况，以及 CDSS 如何影响抗生素处方的基本原理，以及系统开发的详细大纲。在评估领域中，对技术验证进行了分析，并分析了潜在用户与 CDSS 之间的相互作用。在实施领域中，描述了 CDSS 在实际环境中的测试情况以及用于实施和采用 CDSS 的策略。
开发：开发了一个 CDSS，让医生参与进来，以协助经验性抗生素处方。
在验证过程中确定了技术问题，并在新版本的 CDSS 中进行了纠正。进行了一项可用性研究，以评估系统用户交互中的问题。
在 114 名患者中，遵循了 CDSS 生成的抗生素建议。对于 54 名患者，建议没有得到遵守。
本研究描述了一种用于经验性抗生素治疗的 CDSS 的开发和验证，并展示了系统框架用于报告 CDSS 干预的有用性。此外，它还表明 CDSS 建议并不总是被遵守，这与系统的不正确使用有关。
