Margolis A, Bray B E, Gilbert E M, Warner H R
Department of Medical Informatics, University of Utah, Salt Lake City, USA.
Proc Annu Symp Comput Appl Med Care. 1995:228-32.
In this paper we discuss the initial stages of development and evaluation of the HeartMan system, a set of computerized practice guidelines for heart failure management. The concept of computerized guidelines as a hybrid of expert systems and practice guidelines methodologies and techniques is proposed. We show the results of the initial evaluation of the system, which are very promising, although the sample size is small, and the study is retrospective: Of 177 messages, 90% were considered appropriate, of which 97.5% would have been followed. Eight percent of the messages were classified as neutral, and 2% classified as inappropriate. The errors were correctable by changing the logic. The potential technical and sociological barriers to the complete development and clinical use of the system are discussed.
在本文中，我们讨论了HeartMan系统开发与评估的初始阶段，该系统是一套用于心力衰竭管理的计算机化实践指南。我们提出了将计算机化指南作为专家系统与实践指南方法和技术相结合的概念。我们展示了该系统初始评估的结果，尽管样本量较小且研究是回顾性的，但结果很有前景：在177条信息中，90%被认为是合适的，其中97.5%会被遵循。8%的信息被归类为中性，2%被归类为不合适。这些错误可通过更改逻辑来纠正。我们还讨论了该系统全面开发和临床应用中潜在的技术和社会学障碍。
