Visualization of aggregate perioperative data improves anesthesia case planning: A randomized, cross-over trial.
Visualization of aggregate perioperative data improves anesthesia case planning: A randomized, cross-over trial.
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围手术期综合数据的可视化改善了麻醉病例计划：一项随机交叉试验。
DOI：
10.1016/j.jclinane.2020.110114
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发表时间：
2021-03
影响因子：
6.7
通讯作者：
Fabbri DV
中科院分区：
文献类型：
--
作者：
Wanderer JP;Lasko TA;Coco JR;Fowler LC;McEvoy MD;Feng X;Shotwell MS;Li G;Gelfand BJ;Novak LL;Owens DA;Fabbri DV
减少不希望的护理变化的挑战是有效地管理各种各样的所执行的外科手术。虽然一个组织可能执行数千种类型的案例，但隐私和后勤限制阻止了对以前案例的审查，以了解以前的做法。为了弥合这一差距，我们开发了一个系统，用于从麻醉记录中提取关键数据。我们的目标是确定使用该系统是否会改善麻醉住院医师的病例计划性能。随机交叉试验。范德比尔特大学医学中心我们开发了一种基于网络的数据可视化工具，用于审查去识别化的麻醉记录。招募了第一年的麻醉住院医师，并进行了模拟病例计划任务（例如，选择麻醉剂类型），在基线评估后使用随机交叉设计在6个病例场景中进行。一种算法根据住院医师在既往麻醉剂中频繁出现的护理成分对病例计划性能进行评分，评分范围为0-4分。线性混合效应回归量化了工具对平均绩效评分的影响，并对潜在的混杂因素进行了调整。我们分析了19名居民的516份调查问卷。平均性能评分为2.55 ± SD 0.32。使用该工具与平均得分改善0.120分相关（95%CI 0.060至0.179; p < 0.001）。此外，从每次评估到下一次评估，观察到由于“学习效应”而导致的0.055分改善（95%CI 0.034至0.077; p < 0.001）。评估评分也与特定病例情景显著相关（p < 0.001）。本研究证明了开发临床数据可视化系统的可行性，该系统可汇总关键麻醉信息，并发现工具的使用适度提高了住院医师在模拟病例计划中的表现。
A challenge in reducing unwanted care variation is effectively managing the wide variety of performed surgical procedures. While an organization may perform thousands of types of cases, privacy and logistical constraints prevent review of previous cases to learn about prior practices. To bridge this gap, we developed a system for extracting key data from anesthesia records. Our objective was to determine whether usage of the system would improve case planning performance for anesthesia residents. Randomized, cross-over trial. Vanderbilt University Medical Center We developed a web-based, data visualization tool for reviewing de-identified anesthesia records. First year anesthesia residents were recruited and performed simulated case planning tasks (e.g., selecting an anesthetic type) across six case scenarios using a randomized, cross-over design after a baseline assessment. An algorithm scored case planning performance based on care components selected by residents occurring frequently among prior anesthetics, which was scored on a 0–4 point scale. Linear mixed effects regression quantified the tool effect on the average performance score, adjusting for potential confounders. We analyzed 516 survey questionnaires from 19 residents. The mean performance score was 2.55 ± SD 0.32. Utilization of the tool was associated with an average score improvement of 0.120 points (95% CI 0.060 to 0.179; p < 0.001). Additionally, a 0.055 point improvement due to the “learning effect” was observed from each assessment to the next (95% CI 0.034 to 0.077; p < 0.001). Assessment score was also significantly associated with specific case scenarios (p < 0.001). This study demonstrated the feasibility of developing of a clinical data visualization system that aggregated key anesthetic information and found that the usage of tools modestly improved residents’ performance in simulated case planning.
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DOI：
10.1007/bf03016633
发表时间：
2007-12-01
期刊：
CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE
影响因子：
--
作者：
Morgan, Pamela J.;Lam-McCulloch, Jenny;Tarshis, Jordan
通讯作者：
Tarshis, Jordan
影响因子：
4.5
作者：
Perer, Adam;Wang, Fei;Hu, Jianying
通讯作者：
Hu, Jianying
影响因子：
5.3
作者：
Starnes, Joseph R.;McEvoy, Matthew D.;Wanderer, Jonathan P.
通讯作者：
Wanderer, Jonathan P.
影响因子：
4.5
作者：
Wright, Aileen P.;Wright, Adam T.;Sittig, Dean F.
通讯作者：
Sittig, Dean F.
影响因子：
6.7
作者：
O'Neill, Liam;Dexter, Franklin;Epstein, Richard H.
通讯作者：
Epstein, Richard H.