信息技术干预对非手术患者使用适当静脉血栓栓塞预防措施的影响:一项系统评价和荟萃分析。
The effect of information technology intervention on using appropriate VTE prophylaxis in non-surgical patients: A systematic review and meta-analysis.
作者信息
Karajizadeh Mehrdad, Hassanipour Soheil, Sharifian Roxana, Tajbakhsh Fatemeh, Saeidnia Hamid Reza
机构信息
Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Epidemiology, Guilan University of Medical Sciences, Rasht, Iran.
出版信息
Digit Health. 2022 Aug 17;8:20552076221118828. doi: 10.1177/20552076221118828. eCollection 2022 Jan-Dec.
INTRODUCTION
Clinical decision support systems (CDSSs) play an important role in summarizing the best clinical practices, thereby promoting high standards of care in specific medical fields. These systems can serve as tools for gaining knowledge and mediating between clinical guidelines and physicians thereby providing the right information to the right person at the right time.
OBJECTIVE
This review aims to evaluate the effect of CDSSs on adherence to guidelines for venous thromboembolism (VTE) prophylaxis and VTE events compared to routine care without CDSSs in non-surgical patients.
METHODS
In order to conduct a systematic literature review, the published studies were identified through screening EMBASE, the international clinical trials registry, OVID, Cochrane database, PubMed, ISI Web of Science, and Scopus databases, from 1982 to March 2021. The included studies were reviewed by two independent reviewers; the proportion of patients that correctly received VTE prophylaxis has been next extracted for further analysis. Additionally, patients were divided into two groups: CDSS-recommended VTE prophylaxis and routine care without using a CDSS.
RESULTS
Twelve articles (three randomized controlled trials, seven prospective cohort trials, and two retrospective cohort trials) were in fine analyzed. The use of CDSSs is found to be associated with a significant increase in the rate of using the appropriate prophylaxis for VTE ( < 0.05) and a significant decrease in the incidence of VTE ( < 0.05).
CONCLUSION
Implementation of CDSSs can help improving the appropriate use of VTE prophylaxis in non-surgical patients. Further, evidence-based and interventional studies on the development of CDSSs can provide more in-depth knowledge on both this tool design and efficiency.
引言
临床决策支持系统(CDSS)在总结最佳临床实践方面发挥着重要作用,从而在特定医学领域促进高标准的医疗护理。这些系统可作为获取知识的工具,并在临床指南与医生之间起到中介作用,从而在正确的时间为正确的人提供正确的信息。
目的
本综述旨在评估与非手术患者中不使用CDSS的常规护理相比,CDSS对静脉血栓栓塞(VTE)预防指南的依从性及VTE事件的影响。
方法
为进行系统的文献综述,通过筛选1982年至2021年3月期间的EMBASE、国际临床试验注册库、OVID、Cochrane数据库、PubMed、ISI科学网和Scopus数据库来识别已发表的研究。纳入的研究由两名独立的评审员进行审查;接下来提取正确接受VTE预防的患者比例以进行进一步分析。此外,患者被分为两组:CDSS推荐的VTE预防组和不使用CDSS的常规护理组。
结果
对12篇文章(3项随机对照试验、7项前瞻性队列试验和2项回顾性队列试验)进行了详细分析。发现使用CDSS与VTE适当预防使用率的显著增加(<0.05)以及VTE发生率的显著降低(<0.05)相关。
结论
实施CDSS有助于提高非手术患者中VTE预防的适当使用率。此外,关于CDSS开发的循证研究和干预性研究可以提供关于该工具设计和效率的更深入知识。
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