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前列腺癌护理中的临床决策制定——评估 EAU 指南的使用和新型决策支持软件。

Clinical decision making in prostate cancer care-evaluation of EAU-guidelines use and novel decision support software.

机构信息

Department of Urology, University Hospital Basel, Basel, Switzerland.

Research and Analytic Services University Hospital Basel, Basel, Switzerland.

出版信息

Sci Rep. 2024 Aug 18;14(1):19113. doi: 10.1038/s41598-024-70292-y.

Abstract

Keeping up to date with the latest clinical advances in prostate cancer can be challenging. We investigated the impact of guideline use on quality of treatment decisions as well as the impact of a novel, CE-certified clinical decision support tool (Siemens AIPC software) on the amount of time clinicians spend on decision-making in a multicenter setting. Ten urologists assessed ten clinical cases (screening and localized prostate cancer) in three settings: without support, using a digital version of the EAU guidelines, and with the AIPC tool, resulting in 300 clinical decisions. Comparison involved time spent, decision correct- and completeness. Using AIPC compared to digital guidelines led to a significant reduction of expenditure of time at a per case level (3.57 min and 0:14 min, p < 0.01) and for overall time per urologist (39.45 min and 02:20 min, p < 0.01). Decision options without guidelines support, online guideline usage and usage of AIPC were complete in 61%, 80% and 100%, respectively (p < 0.01). Decision making without guidelines support, online guideline usage and usage of AIPC was correct including all options in 28%, 66% and 100%, respectively (p < 0.01).Clinical decision support systems have the potential to reduces decision-making time and to enhance decision quality.

摘要

跟上前列腺癌的最新临床进展可能具有挑战性。我们研究了指南使用对治疗决策质量的影响,以及一种新的、CE 认证的临床决策支持工具(西门子 AIPC 软件)对多中心环境中临床医生决策时间的影响。10 名泌尿科医生在三种情况下评估了 10 个临床病例(筛查和局部前列腺癌):无支持、使用 EAU 指南的数字版本以及使用 AIPC 工具,共做出 300 个临床决策。比较涉及花费的时间、决策的正确性和完整性。与数字指南相比,使用 AIPC 导致每个病例的时间支出显著减少(3.57 分钟和 0:14 分钟,p<0.01),每位泌尿科医生的总时间也显著减少(39.45 分钟和 02:20 分钟,p<0.01)。无指南支持的决策选项、在线指南使用和 AIPC 使用的决策选项的完整性分别为 61%、80%和 100%(p<0.01)。无指南支持、在线指南使用和 AIPC 使用的决策的正确性(包括所有选项)分别为 28%、66%和 100%(p<0.01)。临床决策支持系统有可能减少决策时间并提高决策质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6394/11330959/ff02768c92fd/41598_2024_70292_Fig1_HTML.jpg

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