Morris A H
Department of Medicine, LDS Hospital, Salt Lake City, UT 84143.
New Horiz. 1993 Nov;1(4):593-602.
Protocol control of severely ill ICU patients seems feasible. A satisfactory computer infrastructure makes protocol control practical. A reported four-fold survival rate increase associated with protocol control of ventilatory management of adult respiratory distress syndrome patients suggests that it is not harmful. Protocol control represents a medical decision-support approach for standardizing therapy. Computerized protocols might provide a solution to the nonuniformity of care in clinical ICU practice and investigation. My colleagues and I can envision a multicenter consortium of hospitals equipped to carry out computerized protocol-controlled care. Such a consortium could rapidly complete large, randomized, clinical trials under computerized protocol control. This arrangement could provide much more definitive results than are currently possible. Interpretation of outcomes research results should thereby be made easier and conclusions should be more credible and more likely to contribute to medical policy formulation.
对重症监护病房（ICU）的重症患者进行方案控制似乎是可行的。令人满意的计算机基础设施使方案控制具有实际操作性。据报道，对成人呼吸窘迫综合征患者的通气管理进行方案控制可使生存率提高四倍，这表明该方法并无危害。方案控制代表了一种使治疗标准化的医学决策支持方法。计算机化方案可能为临床ICU实践和研究中护理的不一致性提供解决方案。我和我的同事可以设想一个配备了实施计算机化方案控制护理设备的多中心医院联盟。这样一个联盟可以在计算机化方案控制下迅速完成大型随机临床试验。这种安排可以提供比目前可能得到的结果更具确定性的结果。因此，结果研究结果的解释应该会更容易，结论应该会更可信，并且更有可能为医疗政策的制定做出贡献。
