Trade-offs in producing patient-specific recommendations from a computer-based clinical guideline: a case study.
Trade-offs in producing patient-specific recommendations from a computer-based clinical guideline: a case study.
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根据基于计算机的临床指南生成针对患者的建议的权衡：案例研究。
DOI：
10.1136/jamia.1995.96010392
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
Frawley,SJ
中科院分区：
文献类型：
--
作者：
Miller,PL;Frawley,SJ
该案例研究探讨了1）从基于计算机的临床实践指南中获得患者特定建议需要多少在线临床数据，2）越来越多的在线临床数据的可用性是否可能允许这些建议具有更高的特异性，以及3）增加的特异性是否一定是可取的。分析了由卫生保健政策和研究机构制定的成人急性术后疼痛管理指南的“快速参考指南”版本。患者特定的数据项可能被用来为特定病例定制计算机的输出，这些数据项被分为粗略的类别，这取决于它们在线可用的可能性以及它们从在线临床数据中确定的容易程度。分析患者特定的建议，以确定产生的文本量在多大程度上取决于不同类别数据的在线可用性。然而，对示例建议的审查表明，高度具体性并不总是可取的。这项研究提供了一个具体的例子，如何丰富的在线临床数据可以影响患者的具体建议，并描述了一些相关的设计权衡转换成一个互动的，基于计算机的形式临床指南。
This case study explored 1) how much online clinical data is required to obtain patient-specific recommendations from a computer-based clinical practice guideline, 2) whether the availability of increasing amounts of online clinical data might allow a higher specificity of those recommendations, and 3) whether that increased specificity is necessarily desirable. The “quick reference guide” version of the guideline for acute postoperative pain management in adults, developed by the Agency for Health Care Policy and Research, was analyzed. Patient-specific data items that might be used to tailor the computer's output for a particular case were grouped into rough categories depending on how likely they were to be available online and how readily they might be determined from online clinical data. The patient-specific recommendations were analyzed to determine to what degree the amount of text produced depended on the online availability of different categories of data. An examination of example recommendations, however, illustrated that high specificity may not always be desirable. The study provides a concrete illustration of how the richness of online clinical data can affect patient-specific recommendations, and describes a number of related design trade-offs in converting a clinical guideline into an interactive, computer-based form.