US and Dutch Perspectives on the Use of COVID-19 Clinical Prediction Models: Findings from a Qualitative Analysis.
US and Dutch Perspectives on the Use of COVID-19 Clinical Prediction Models: Findings from a Qualitative Analysis.
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DOI：
10.1177/0272989x231152852
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发表时间：
2023-05
影响因子：
3.6
通讯作者：
Hajizadeh, Negin
中科院分区：
文献类型：
--
作者：
Basile, Melissa J.;Helmrich, I. R. A. Retel;Park, Jinny G.;Polo, Jennifer;Rietjens, Judith A. C.;van Klaveren, David;Zanos, Theodoros P.;Nelson, Jason;Lingsma, Hester F.;Kent, David M.;Alsma, Jelmer;Verdonschot, R. J. C. G.;Hajizadeh, Negin
关键词：
2019冠状病毒病（COVID-19）的临床预测模型（cpm）可能支持临床决策、治疗和沟通。然而，人们对使用cpm进行COVID-19决策的态度尚不清楚。在美国（US）和荷兰（NL）的医疗保健提供者、COVID-19幸存者和代理人（即亲人/代理决策者）中进行了在线焦点小组和访谈。半结构化问题探讨了COVID-19护理的临床决策经验以及实施cpm的促进因素和障碍。在美国，我们在2021年1月至2021年7月期间与(1)提供者和(2)COVID-19的代理人和幸存者进行了四个在线焦点小组。在NL中，我们在2021年5月至2021年7月期间与(1)提供者和(2)COVID-19的代理人和幸存者进行了三个焦点小组和四次个人访谈。提供者表达了对CPM有效性的担忧，并相信患者可能会将CPM预测解释为绝对的。他们认为cpm在资源分配、分类、教育和研究方面具有潜在的用处。几名代孕母亲和感染COVID-19的人没有得到预后估计，但他们认为这些信息会支持和影响他们的决策。有限数量的参与者认为这些数据不适用于他们，他们或他们的亲人可能无法幸存，因为预后不佳可能意味着放弃治疗。由于担心CPM的有效性和患者对结果预测的解释，许多提供者对对COVID-19患者使用CPM持保留态度。然而，一些在COVID-19中幸存下来的人和他们的代理人表示，他们会发现这些信息对决策有用。因此，可能需要提供信息来提高提供者水平的舒适度以及患者和代理对cpm的理解。
Clinical prediction models (CPMs) for coronavirus disease 2019 (COVID-19) may support clinical decision-making, treatment, and communication. However, attitudes about using CPMs for COVID-19 decision-making are unknown. Online focus groups and interviews were conducted among healthcare providers, survivors of COVID-19, and surrogates (i.e., loved-ones/surrogate decision-makers) in the United States (US) and the Netherlands (NL). Semi-structured questions explored experiences about clinical decision-making in COVID-19 care and facilitators and barriers for implementing CPMs. In the US, we conducted four online focus groups with (1) providers and (2) surrogates and survivors of COVID-19 between January 2021 and July 2021. In the NL, we conducted three focus groups and four individual interviews, with (1) providers and (2) surrogates and survivors of COVID-19 between May 2021 and July 2021. Providers expressed concern about CPM validity and the belief that patients may interpret CPM predictions as absolute. They described CPMs as potentially useful for resource allocation, triaging, education, and research. Several surrogates and people who had COVID-19 were not given prognostic estimates but believed this information would have supported and influenced their decision-making. A limited number of participants felt the data would not have applied to them and that they or their loved ones may not have survived, as poor prognosis may have suggested withdrawal of treatment. Many providers had reservations about using CPMs for people with COVID-19 due to concerns about CPM validity and patient-level interpretation of the outcome predictions. However, several people who survived COVID-19 and their surrogates indicated that they would have found this information useful for decision-making. Therefore, information provision may be needed to improve provider-level comfort and patient and surrogate understanding of CPMs.
影响因子：
9.3
作者：
van Klaveren, David;Zanos, Theodoros P.;Nelson, Jason;Levy, Todd J.;Park, Jinny G.;Helmrich, Isabel R. A. Retel;Rietjens, Judith A. C.;Basile, Melissa J.;Hajizadeh, Negin;Lingsma, Hester F.;Kent, David M.
通讯作者：
Kent, David M.