EVALUATION OF APACHE 111 CLINICAL INFORMATION SYSTEM

APACHE 111 临床信息系统的评估

• 批准号: 2237814
• 负责人: WILLIAM A KNAUS
• 金额: $ 14.68万
• 依托单位: GEORGE WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1993
• 资助国家: 美国
• 起止时间: 1993-09-30 至 1996-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2237814
• 关键词: automated health care system; computer assisted medical decision making; computer system design /evaluation; health care quality; human subject; information systems; intensive care; interview; prognosis

The goal of this proposal is to perform a comprehensive evaluation of the APACHE III Clinical Decision and ICU Management Support System (System). The System is an automated, computerized, clinical and management program that provides previously unavailable predictive and evaluative information to intensive care (ICU) clinicians and hospital administrators. This turnkey system provides objective risk estimates for key clinical outcomes (i.e., hospital death, length of stay, resource utilization) in real time for critically ill adults treated in intensive care units. The system was developed from the APACHE III (Acute Physiology, Age, and Chronic Health Evaluation) Prognostic Scoring System. The long-term objective of this proposal is to determine whether and how the timely provision of a new form of computerized, patient specific, prognostic information will influence existing relations between computation and language and between formal logic and current clinical practices. We will evaluate the impact of the APACHE III system on clinical decision making, patient outcomes, administrative and institutional decision making, user acceptance, system design, and its integration with existing laboratory and ICU monitoring systems. These aims will be addressed through a combination of direct data processing from the APACHE III system and through a coordinated series of interviews with ICU clinicians. The APACHE III system's capabilities speak directly to two fundamental issues of computerized information systems - The interaction of formal (e.g., objective) logic and current clinical decision making and the effect of computation on language and communication. Among the important issues that this evaluation of APACHE III will address are: How does the numeric and color-coded representations of patient status influence physician knowledge, attitudes, and communication? Are the barriers to acceptance of computerized information systems primarily technical or perceptual? What are the major positive and negative influences of a computerized decision support system and how can future evaluative efforts best detect them? The results of this evaluation will be of central importance to medical informatics and will be generalizable to a wide variety of future, clinical alert, decision support, and artificial intelligence systems.

本提案的目标是对 APACHE III临床决策和ICU管理支持系统（系统）。 该系统是一个自动化，计算机化，临床和管理程序 提供了以前无法预测和评估的 向重症监护（ICU）临床医生和医院提供信息 管理员。 该交钥匙系统提供客观的风险评估 对于关键临床结果（即，住院死亡，住院时间，资源 真实的时间）， 护理单位。 该系统是从APACHE III（急性 生理学、年龄和慢性健康评估）预后评分 系统 本建议的长期目标是确定是否以及如何 及时提供一种新的计算机化的、针对病人的、 预测信息将影响现有的关系 计算和语言之间的关系，以及形式逻辑和当前临床 实践 我们将评估APACHE III系统的影响， 临床决策、患者结局、管理和 机构决策，用户接受，系统设计，及其 与现有的实验室和ICU监测系统集成。 这些 目标将通过直接数据处理和 从APACHE III系统，并通过一系列协调的采访， ICU临床医生 APACHE III系统的能力直接说明了两个基本问题， 计算机化信息系统的问题. (e.g.,客观）逻辑和当前临床决策以及 计算对语言和交流的影响。 其中重要的 APACHE III评估将解决的问题是： 患者状态影响的数字和颜色编码表示 医生的知识、态度和沟通？ 这些障碍 接受计算机化信息系统，主要是技术或 知觉？ a的主要积极和消极影响是什么 计算机化的决策支持系统，以及未来如何评估 最好的方法是检测它们。 这项评估的结果将是至关重要的医疗 并将推广到各种未来， 临床警报、决策支持和人工智能系统。