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Development of Single-Screen Clinical Decision Support to Increase Guideline-Based Weight Management and Comorbidity Care

开发单屏临床决策支持以加强基于指南的体重管理和合并症护理

基本信息

批准号：
9789921
负责人：
Christy Boling Turer
金额：
$ 8.1万
依托单位：
UT SOUTHWESTERN MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-21 至 2021-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9789921
关键词：
Address Adult Age Algorithms Blood Pressure Cardiovascular Diseases Caring Child Childhood Cognitive Communication Comorbidity Complex Conflict (Psychology)Consensus Decision Support Model Decision Support Systems Decision Trees Detection Development Diagnosis Diagnostic Diet Electronic Health Record Elements Engineering Evaluation Fast Healthcare Interoperability Resources Funding Future Gender Goals Guidelines Health Healthcare Heart Diseases Height Hypertension Informatics Information Specialists Internet Intervention Laboratory Study Lead Life Style Medicine Methods Morbidity - disease rate Obesity Obesity Related Hypertension Obesity associated disease Overweight Patients Pharmaceutical Preparations Plant Roots Population Primary Health Care Provider Psyche structure Publishing Recommendation Research Resistance Risk Factors Structure Techniques Testing Time Update Variant Weight Weight maintenance regimen Work base blood pressure regulation care delivery care providers clinical decision support clinical practice computerized dashboard disorder prevention follow-up heart disease risk hypertension treatment improved operation pediatrician point of care satisfaction screening screening guidelines support tools symposium task analysis tool

项目摘要

PROJECT SUMMARY Obesity-related hypertension is now diagnosed in children. If undiagnosed and untreated, hypertension increases the likelihood of serious health consequences. To address this problem, we must prepare pediatricians, once focused on anticipatory guidance and disease prevention, to surveil and treat children with overweight and obesity for high blood pressure and hypertension. Because blood-pressure norms in children vary with age, gender, and height, it is difficult to identify three blood-pressure elevations to diagnose hypertension. Our long-term goals are to: 1) identify how to support pediatricians in this major practice paradigm shift, 2) improve delivery of guideline-based weight-management and hypertension care, 3) improve long-term weight management, and 4) reduce morbidity from unrecognized obesity-related disease. Our previous studies revealed: (1) specific guideline-recommended weight management clinical practices are effective, but too-rarely used, (2) providers fail to recognize elevated blood pressures in overweight children, (3) determining pediatric hypertension criteria is a complex, error-prone task, and (4) this impediment to hypertension care can be removed by hypertension clinical decision support. These results led us to ask if we could collate and present to providers information needed to deliver both guideline-based weight management and hypertension care. However, in drafting a potential decision-support system, we confronted age and weight-status variations in screening and evaluation guidelines for weight management and hypertension. This led to our central hypothesis that: (1) expert consensus will resolve conflicts and coordinate guideline-based recommendations for weight management and hypertension care, and (2) application of cognitive-engineering methods currently underused in medicine will enable us to build a single-screen weight- management plus hypertension clinical-decision-support interface that is: (1) easy to use (reduces number of task steps needed), (2) error-resistant (limits number of cognitively demanding steps, including mental calculations and recall), and (3) helpful for efficiently identifying and taking action on key information needed to deliver guideline-based weight-management and hypertension care. Our proposed research will broadly impact the field by transforming the current primary-care weight- management clinical practice paradigm to include guideline-based hypertension care. If successful, the resulting clinical-decision-support model can be applied in the future to address other obesity-related comorbidities. Through future funding, the fully developed tool will be used to test whether weight-management plus hypertension clinical decision support improves weight and blood-pressure control. This work holds great potential to support pediatricians in a major practice paradigm shift and delivery of guideline-based weight management and hypertension care. Delivery of this care holds great potential for reducing future cardiovascular disease in adulthood from unrecognized, untreated obesity and hypertension in children.

项目总结