Wanger P, Martin L
Glaucoma Service, St. Erik's Eye Hospital, Stockholm, Sweden.
Acta Ophthalmol Scand. 1997 Dec;75(6):700-4. doi: 10.1111/j.1600-0420.1997.tb00634.x.
To evaluate the feasibility of computerized decision support in the management of patients with open angle glaucoma or ocular hypertension.
Based on a Swedish consensus document a computer program was developed, which provided one of 25 different recommendations for appropriate action. In 373 patient visits to seven different eye clinics, the program's recommendations were compared to the actual decisions made by the responsible ophthalmologists.
Notable differences were observed between the clinics' management strategies, especially regarding follow-up frequency and start or increase of anti-glaucoma treatment. The program's recommendations conformed with the clinical decisions in 23 to 92% of the cases when a standard management strategy was simulated. The concordance increased to 93 to 100%, when policy differences between the clinics were taken into account.
Clinical decision-making in the management of patients with ocular hypertension or open angle glaucoma can be implemented in a computer program. The optimum management protocol remains to be defined.
评估计算机化决策支持在开角型青光眼或高眼压症患者管理中的可行性。
基于一份瑞典共识文件开发了一个计算机程序，该程序为适当行动提供25种不同建议中的一种。在对7家不同眼科诊所的373次患者就诊中，将该程序的建议与负责的眼科医生做出的实际决策进行了比较。
各诊所的管理策略之间存在显著差异，尤其是在随访频率以及抗青光眼治疗的起始或增加方面。当模拟标准管理策略时，该程序的建议在23%至92%的病例中与临床决策相符。当考虑到诊所之间的政策差异时，一致性提高到93%至100%。
高眼压症或开角型青光眼患者管理中的临床决策可以在计算机程序中实现。最佳管理方案仍有待确定。
