A distributed system for support and explanation of shared decision-making in the prenatal testing domain
A distributed system for support and explanation of shared decision-making in the prenatal testing domain
复制标题
用于支持和解释产前检测领域共享决策的分布式系统
DOI：
10.1016/j.jbi.2008.09.004
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发表时间：
2009
影响因子：
4.5
通讯作者：
Yuval Shahar
中科院分区：
文献类型：
--
作者：
I. Segal;Yuval Shahar
医疗领域涉及众多的测试和治疗，其种类之多使护理提供者和患者都感到困惑。许多决定取决于患者的偏好。因此，明确涉及患者及其偏好的共同决策势在必行，但也需要足够的解释性基础设施。我们介绍了一个分布式应用程序，PANDEX，通过使用决策分析方法，帮助患者和护理提供者达到最佳决策。PANDEX原型基于通用架构，专注于遗传产前咨询领域，旨在根据患者的临床数据和偏好计算最佳治疗策略。我们研究的一个主要重点是开发几种类型的深入的敏感性和重要性分析方法，并在系统中嵌入相应的图形工具的实施，以帮助患者充分理解推荐的策略。6名遗传顾问对PANDEX进行的初步评估显示，相对不愿意与PANDEX合作（平均值=2.16±0.98（SD），量表为1-5），但倾向于同意其推荐的策略（平均值=3.48±1.4），并同意其提供建议策略见解的能力（3.28±1.23）。顾问认为PANDEX对患者是一种潜在的有用工具。
Medical domains involve numerous tests and treatments, the sheer variety of which confounds both care providers and patients. Many of the decisions depend on the patient’s preferences. Shared decision-making, which explicitly involves the patients and their preferences, is therefore imperative, but requires also a sufficient explanatory infrastructure. We introduce a distributed application, PANDEX, that, by using decision-analytic methods, assists patients and care providers to reach optimal decisions. Based on a generic architecture, the PANDEX prototype, which focuses on the domain of genetic prenatal consultation, is designed to calculate the optimal treatment strategy based on the patient’s clinical data and preferences. A major focus of our study was on developing several types of in-depth sensitivity and importance analysis methods and on the implementation of the respective graphical tools embedded in the system, to help the patient fully understand the recommended strategy. A preliminary assessment of PANDEX by six genetic consultants demonstrated a relative unwillingness to work with PANDEX (mean=2.16±0.98 (SD), on a scale of 1–5), but a tendency to agree with its recommended strategies (mean=3.48±1.4) and with its capability to provide insights into the recommended strategies (3.28±1.23). PANDEX was considered by the consultants to be a potentially useful tool for patients.
影响因子：
7.4
作者：
Park A;Hartzler AL;Huh J;McDonald DW;Pratt W
通讯作者：
Pratt W