Bringing cohort studies to the bedside: framework for a "green button' to support clinical decision-making
Bringing cohort studies to the bedside: framework for a "green button' to support clinical decision-making
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DOI：
10.2217/cer.15.12
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发表时间：
2015-01-01
影响因子：
2.1
通讯作者：
Coiera, Enrico
中科院分区：
文献类型：
--
作者：
Gallego, Blanca;Walter, Scott R.;Coiera, Enrico
在提供护理时，临床医生应注意临床实践指南，该指南根据现有证据提供建议。然而，指南可能不适用于患有合并症的个体患者，因为他们通常被排除在临床试验之外。指南也往往不提供有关风险、次级效应和长期结果的相关证据。查询类似患者的电子健康记录可以为许多人提供替代证据来源，以告知决策。重要的是要开发方法来支持这些个性化的观察性研究，了解这些方法何时可以提供有效的结果，并验证和整合这些结果与临床试验。
When providing care, clinicians are expected to take note of clinical practice guidelines, which offer recommendations based on the available evidence. However, guidelines may not apply to individual patients with comorbidities, as they are typically excluded from clinical trials. Guidelines also tend not to provide relevant evidence on risks, secondary effects and long-term outcomes. Querying the electronic health records of similar patients may for many provide an alternate source of evidence to inform decision-making. It is important to develop methods to support these personalized observational studies at the point-of-care, to understand when these methods may provide valid results, and to validate and integrate these findings with those from clinical trials.