Clayton P D, Hripcsak G
Department of Medical Informatics, Columbia-Presbyterian Medical Center, New York, NY 10032, USA.
Int J Biomed Comput. 1995 Apr;39(1):59-66. doi: 10.1016/0020-7101(94)01080-k.
To address the recognized problems associated with information overload and limited human memory, computer-based systems which help healthcare providers use information to make better decisions have been developed and implemented. These decision aids are designed to improve the quality and reduce the cost of healthcare. Currently, the most widely used computer application is to simply provide needed facts about the patient in an organized and timely fashion. Additionally, healthcare workers can access literature, ask questions of aggregates of patient data for clinical or administrative decisions, receive warnings or suggestions when the patient's data satisfy certain logical rules receive critiques when proposing therapies or ordering diagnostic tests, receive guidelines for standards of care, access programs which analyze tradeoffs and likelihoods of alternative outcomes (decision analysis) and receive lists of differential diagnoses. Given this wonderful panoply of capabilities, the question becomes 'why aren't more people using these aids and what are the demonstrated benefits of such capabilities?' In this paper we review the types of decision aids which have been successfully implemented and the challenges to implementation (knowledge representation, connections to databases, need for comprehensive, coded databases and evaluation of benefits).
为解决与信息过载和人类记忆有限相关的公认问题，已开发并实施了基于计算机的系统，以帮助医疗保健提供者利用信息做出更好的决策。这些决策辅助工具旨在提高医疗保健的质量并降低成本。目前，使用最广泛的计算机应用程序是简单地以有组织且及时的方式提供有关患者的所需事实。此外，医护人员可以查阅文献、针对临床或行政决策询问患者数据汇总情况、当患者数据满足某些逻辑规则时接收警告或建议、在提出治疗方案或订购诊断测试时接收批评意见、接收护理标准指南、访问分析权衡和替代结果可能性的程序（决策分析）以及接收鉴别诊断列表。鉴于这些出色的功能，问题就变成了“为什么没有更多人使用这些辅助工具，以及这些功能有哪些已得到证明的益处？”在本文中，我们回顾了已成功实施的决策辅助工具类型以及实施过程中面临的挑战（知识表示、与数据库的连接、对全面编码数据库的需求以及效益评估）。
