EVALUATION OF APACHE 111 CLINICAL INFORMATION SYSTEM

这项提案的目标是对 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、计算机化的临床和管理程序 这提供了以前无法获得的预测性和评估性 向重症监护(ICU)临床医生和医院提供的信息 管理员。这个交钥匙系统提供了客观的风险评估。 对于关键临床结果(例如，住院死亡、住院时间、资源 利用)对重症监护的危重成人进行实时治疗 护理室。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。 这项提案的长期目标是确定是否以及如何 及时提供一种新形式的计算机化的、针对患者的、 预后信息将影响现有的 计算与语言以及形式逻辑与现代临床的关系 练习。我们将评估阿帕奇III系统对以下方面的影响 临床决策、患者结果、管理和 机构决策、用户接受、系统设计和ITS 与现有实验室和ICU监测系统集成。这些 AIMS将通过组合直接数据处理来解决 通过一系列协调一致的采访 和重症监护室的临床医生。 ApacheIII系统功能直接说明了两个基本问题 计算机化信息系统的问题--形式之间的相互作用 (例如，客观的)逻辑和当前的临床决策 计算对语言和交流的影响。在重要的 这次对ApacheIII的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？是不是阻碍 接受计算机化的信息系统，主要是技术或 感性的？A的主要正面和负面影响是什么？ 计算机化决策支持系统及其未来评估 努力能最好地发现他们吗？ 这项评估的结果将对医疗保健具有重要意义 信息学，并将被推广到各种各样的未来， 临床警报、决策支持和人工智能系统。

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.