Translating clinical and patient-reported data to tailored shared decision reports with predictive analytics for knee and hip arthritis.
Translating clinical and patient-reported data to tailored shared decision reports with predictive analytics for knee and hip arthritis.
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DOI：
10.1007/s11136-020-02557-8
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发表时间：
2021-11
期刊：
影响因子：
--
通讯作者：
Lavallee DC
中科院分区：
文献类型：
--
作者：
Franklin PD;Zheng H;Bond C;Lavallee DC
新的信息学工具可以将基于证据的信息转换为个性化的预测报告，为临床共享决策服务。我们开发了一个基于网络的系统来收集患者报告的结果(PRO)和医疗风险因素，并比较对国家登记数据的反应。该系统为个别患者生成预测结果，并生成供临床使用的报告，以支持决策。我们为寻求骨科评估的膝关节和髋关节关节炎患者提供报告的开发、演示和实施这份基于支持的、共享的决策报告的早期经验。反复的患者和临床医生访谈定义了报告内容和视觉显示。该网络系统支持：(A)在家中或在办公室收集有利因素和风险数据；(B)对照国家数据对答复进行自动统计处理；(C)如果选择手术，对可能的疼痛缓解和功能收益进行个性化估计；以及(D)支持共同决定的图形报告。在一项正在进行的整群随机试验中，该系统在12个地点与26名外科医生一起实施。临床医生和患者建议将疼痛和功能以及临床风险因素(例如体重指数、吸烟)作为讨论的框架。颜色和图形支持患者的理解。到目前为止，7891名患者在访问前完成了评估，56%的患者同意参与研究。98%的患者生成了报告，68%的患者回忆起与他们的外科医生一起审阅了报告。信息学解决方案可以生成及时的、量身定制的办公室报告，包括专业知识和预测性分析。患者成功地完成了就诊前的PRO评估，临床医生和患者重视该报告，以支持共同的手术决定。本文的在线版本(10.1007/s11136-020-02557-8)包含向授权用户提供的补充材料。
New informatics tools can transform evidence-based information to individualized predictive reports to serve shared decisions in clinic. We developed a web-based system to collect patient-reported outcomes (PROs) and medical risk factors and to compare responses to national registry data. The system generates predicted outcomes for individual patients and a report for use in clinic to support decisions. We present the report development, presentation, and early experience implementing this PRO-based, shared decision report for knee and hip arthritis patients seeking orthopedic evaluation. Iterative patient and clinician interviews defined report content and visual display. The web-system supports: (a) collection of PROs and risk data at home or in office, (b) automated statistical processing of responses compared to national data, (c) individualized estimates of likely pain relief and functional gain if surgery is elected, and (d) graphical reports to support shared decisions. The system was implemented at 12 sites with 26 surgeons in an ongoing cluster randomized trial. Clinicians and patients recommended that pain and function as well as clinical risk factors (e.g., BMI, smoking) be presented to frame the discussion. Color and graphics support patient understanding. To date, 7891 patients completed the assessment before the visit and 56% consented to study participation. Reports were generated for 98% of patients and 68% of patients recalled reviewing the report with their surgeon. Informatics solutions can generate timely, tailored office reports including PROs and predictive analytics. Patients successfully complete the pre-visit PRO assessments and clinicians and patients value the report to support shared surgical decisions. The online version of this article (10.1007/s11136-020-02557-8) contains supplementary material, which is available to authorized users.
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