Using Medical Informatics Principles to Enhance Development and Dissemination of

描述（由申请人提供）： 该提案描述了美国精神病学研究与教育研究所的一个为期3年的项目，该项目旨在使用医学信息学原理来加强基于证据的临床实践指南的开发和传播，以治疗重度抑郁症患者，这种疾病具有重大的公共卫生后果。临床实践指南由许多医学专业组织开发和发布，综合现有证据并推荐特定治疗或实践，最终目标是改善患者结局和护理质量。然而，如果指南的内容不是最新的，或者如果在忙碌的临床环境中，在护理点不容易访问和理解指南，则临床医生可能不会使用指南。这两个问题都是使用传统叙述性信息结构制定的指南的责任。根据这一提议，已发表的关于抑郁症治疗的研究将被收集、评估和组织在一个关系数据库中。在同一个数据库中，接下来将开发实践建议模块，每个模块都侧重于对质量有潜在影响的临床问题。模块还将提供讨论和链接到支持证据。治疗重度抑郁症患者的精神科医生的临床信息需求将使用已建立的实践研究网络进行评估。研究结果将为设计一个数据库驱动的网络系统提供信息，该系统具有增强的搜索功能，可用于出版准则模块。该系统的可用性将经过反复的用户测试和改进。如果成功的话，这种开发方法和出版技术可能会被用于其他精神疾病的指南，并可能被其他指南开发者复制，从而加强医学研究向临床实践的转化。

DESCRIPTION (provided by applicant): This proposal describes a 3-year project by the American Psychiatric Institute for Research and Education to use medical informatics principles to enhance the development and dissemination of evidence-based clinical practice guidelines for the treatment of patients with major depressive disorder, an illness with significant public health consequences. Clinical practice guidelines developed and published by many medical specialty organizations, synthesize available evidence and recommend specific treatments or practices, with the ultimate goal of improving patient outcomes and quality of care. Clinicians may not use guidelines, however, if the contents are not up-to-date or if the guidelines are not easy to access and understand at the point of care within a busy clinical environment. Both problems are liabilities of guidelines developed using a traditional narrative information structure. Under this proposal, published research studies on the treatment of depression will be collected, evaluated, and organized within a relational database. Within the same database, modules of practice recommendations will next be developed each focused on a clinical question with potential impact on quality. Modules will also provide discussion and links to the supporting evidence. The clinical information needs of psychiatrists who treat patients with major depressive disorder will be evaluated using an established practice research network. Results will inform the design of a database-driven Web-based system with enhanced search functionality for publication of the guideline modules. The usability of the system will undergo iterative user testing and improvement. If successful, this development approach and the publication technology may be implemented for guidelines on other psychiatric disorders and may be replicated by other guideline developers, enhancing the translation of medical research into clinical practice.