实验室选择性报告对医生抗生素处方行为的影响模型及整群随机对照干预研究

不合理使用抗生素进一步加剧了抗生素耐药(AMR)，严重威胁全球健康和经济发展。实验室报告作为指导医生合理抗生素处方的重要工具，对解决前述问题意义重大。然而，信息过载导致实验室报告不当理解和运用，阻碍了合理抗生素处方行为，因此选择性报告至关重要，但基础研究十分缺乏。.本研究拟基于实验室报告相关指南等，采用深度访谈法、内容分析法等，多学科交叉形成选择性报告测量工具及其对抗生素处方行为影响的理论模型；基于现场调查、因子分析、结构方程模型等，构建数学模型；采用整群随机对照试验设计和模拟患者设计，借助倍差法、潜成长模型等评估干预效果；采用干预映射、专家启发法等形成技术指南及参数标准等对策。.该研究构建的选择性报告测量工具、模型、技术指南等成果将丰富临床检验学、药物政策学的理论与工具，拓展信息学、管理科学、认知心理学与工程心理学的运用，为指导、规范医生抗生素处方行为、解决全球AMR提供循证证据。

The irrational use of antibiotics further aggravates antimicrobial resistance (AMR), which has heavily threatened global health and economic development. As an important tool for guiding physicians prescribing antibiotics rationally, laboratory reporting is of great significance for addressing AMR and promoting rational use of antibiotics. However, improper understanding and use of laboratory reports due to information overload usually tend to impede rational antibiotic prescribing practice. Selective laboratory reporting is essential, but relevant fundamental research is quite scarce..This study aims to use in-depth interviews, coding techniques of grounded theory, content analysis, etc. to establish selective reporting measurement tools and theoretical model of selective reporting influencing antibiotic prescribing practice on the basis of laboratory reporting related guidelines combined with the real-world data in multidisciplinary view. Spot investigations, factor analysis, structural equation modelling (SEM), etc. will be used to construct the mathematical model of selective reporting influencing antibiotic prescribing practice. A cluster matched randomized controlled trial and standardized patient design will be applied to evaluate intervention effects by means of Difference in Difference (DID), Latent Growth models (LGMs), etc. Finally, intervention mapping approach, expert heuristics, in-depth interviews, etc. will be used to form technical guidelines and parameter standards and put forward countermeasures..The innovative outcomes of this study will be the measurement tools, model, technical guidelines of selective laboratory reporting, which will enrich the theory and tools for clinical laboratory science and pharmaceutical policy, and expand the application of informatics, management science, cognitive psychology and engineering psychology. The findings from the current study will help guide and improve physicians’ antibiotic prescribing practice cost-effectively, as well as provide evidence-based research foundations and practical evidence for addressing global AMR.