Goldman L, Waternaux C, Garfield F, Cohn P F, Strong R, Barry W H, Cook E F, Rosati R, Sherman H
Arch Intern Med. 1981 Nov;141(12):1631-4.
To determine whether physicians would be influenced by the prognostic information in a large coronary artery disease data bank, cardiology faculty and fellows made initial estimates of the prognoses of their patients and then made revised final estimates after seeing the outcome of matched patients (OMP) from the data bank. The faculty cardiologists' original estimates proved to be as accurate as those of the data bank's OMP, and the faculty revised their estimates minimally in response to the data bank's OMP. Conversely, the cardiology fellows' original estimates were less accurate than the data bank's OMP, and under all observed circumstances the fellows responded more to the data bank's OMP than did the faculty. As a result, the accuracy of the fellows' final estimates was similar to the accuracies of both the faculty cardiologists and the data bank's OMP. Computerized data banks seem more likely to have impact when their information is provided to physicians who are relatively inexperienced with the disease in question.
为了确定医生是否会受到大型冠状动脉疾病数据库中预后信息的影响,心脏病学教员和研究员首先对他们患者的预后进行了初步估计,然后在查看了数据库中匹配患者(OMP)的结果后做出了修订后的最终估计。事实证明,心脏病学教员的最初估计与数据库的OMP一样准确,并且教员根据数据库的OMP对他们的估计进行了最小程度的修订。相反,心脏病学研究员的最初估计不如数据库的OMP准确,并且在所有观察到的情况下,研究员对数据库的OMP的反应比教员更大。结果,研究员最终估计的准确性与心脏病学教员和数据库的OMP的准确性相似。当将计算机化数据库的信息提供给对相关疾病相对缺乏经验的医生时,这些数据库似乎更有可能产生影响。