PROTOCOL-BASED COMPUTER REMINDERS, QUALITY OF CARE AND NON-PERFECTABILITY OF MAN
PROTOCOL-BASED COMPUTER REMINDERS, QUALITY OF CARE AND NON-PERFECTABILITY OF MAN
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DOI：
10.1056/nejm197612092952405
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发表时间：
1976-01-01
影响因子：
158.5
通讯作者：
MCDONALD, CJ
中科院分区：
文献类型：
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作者：
MCDONALD, CJ
为了确定是否可以减少临床错误的前瞻性计算机建议的管理简单的临床事件，我研究了9名医生的反应，计算机建议产生的390个协议在一个控制交叉设计。这些协议主要涉及管理的条件（例如，血压升高）或引起（例如，肝毒性）。医生对327个事件中的51%做出了回应，而385个事件中的22%没有给出计算机建议。无论是研究生的培训水平（第一年的研究生或第三年的研究生），也没有医生作为研究和对照组的顺序有统计学显着的整体效果的结果。看来，预期的提醒确实减少了错误，而且这些错误中的许多可能是由于人类作为数据处理器的局限性，而不是由于可纠正的人类缺陷。（《新英格兰医学杂志》295：1351-1355，1976）
To determine whether clinical errors can be reduced by prospective computer suggestions about the management of simple clinical events, I studied the responses of nine physicians to computer suggestions generated by 390 protocols in a controlled crossover design. These protocols dealt primarily with conditions managed (e.g., elevated blood pressure) or caused (e.g., liver toxicity) by drugs. Physicians responded to 51 per cent of 327 events when given, and 22 per cent of 385 events when not given computer suggestions. Neither level of postgraduate training (first-year postgraduate or third-year postgraduate) nor the order in which physicians served as study and control subjects had statistically significant overall effect on the results. It appears that the prospective reminders do reduce errors, and that many of these errors are probably due to man's limitations as a data processor rather than to correctable human deficiencies. (N Engl J Med 295:1351–1355, 1976)