Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, UK.
NHS Gloucestershire Integrated Care Board, Gloucester, UK.
NPJ Prim Care Respir Med. 2024 Nov 27;34(1):40. doi: 10.1038/s41533-024-00401-x.
There is uncertainty about how best to diagnose asthma, especially in primary care where mis-diagnosis is common. To address this, we developed a clinical decision support system (CDSS) for asthma diagnosis in children and young people (aged 5-25 years). This study explored the feasibility and acceptability of the CDSS in UK primary care. We recruited general practices from England and Scotland. The CDSS was available for use during routine consultations for six months. We analysed CDSS usage and, toward the end of the study, undertook qualitative interviews with clinicians who had used the CDSS. Within the 10 practices who completed the study, the CDSS was used by 75 out of 94 clinicians. 11 clinicians from 8 practices were interviewed. The CDSS was acceptable to participants who particularly commented on the ease of use and auto-population of information from the patient record. Barriers to use included the inability to record findings directly into the patient notes and a sense that, whilst possibly useful for trainees and junior colleagues, the CDSS would not necessarily lead to a change in their own practice. The CDSS was generally well received by primary care clinicians, though participants felt it would be most useful for trainees and less experienced colleagues.
在初级保健中,哮喘的诊断存在不确定性,误诊很常见。为了解决这个问题,我们为儿童和年轻人(5-25 岁)开发了一种哮喘诊断的临床决策支持系统(CDSS)。本研究探讨了该 CDSS 在英国初级保健中的可行性和可接受性。我们从英格兰和苏格兰招募了普通诊所。该 CDSS 可在常规咨询期间使用六个月。我们分析了 CDSS 的使用情况,并在研究结束时,对使用过 CDSS 的临床医生进行了定性访谈。在完成研究的 10 家诊所中,有 75 名临床医生使用了 CDSS。对来自 8 家诊所的 11 名临床医生进行了访谈。参与者认为该 CDSS 易于使用且能自动从患者记录中提取信息,因此可以接受。使用的障碍包括无法直接将发现记录到患者记录中,以及尽管该 CDSS 可能对培训生和初级同事有用,但不一定会改变他们自己的实践。该 CDSS 受到初级保健临床医生的普遍欢迎,尽管参与者认为该 CDSS 对培训生和经验较少的同事最有用。