Use of health information technology to reduce diagnostic errors.
Use of health information technology to reduce diagnostic errors.
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DOI：
10.1136/bmjqs-2013-001884
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发表时间：
2013-10
影响因子：
5.4
通讯作者：
Schiff GD
中科院分区：
文献类型：
--
作者：
El-Kareh R;Hasan O;Schiff GD
健康信息技术(HIT)系统有可能减少延迟、遗漏或错误的诊断。我们对HIT诊断的现状进行了描述和分类，并确定了未来的研究方向。使用PubMed、Web of Science、前后参考文献检索和领域专家的贡献进行了多管齐下的文献检索。我们纳入了在临床和实验环境中评估的HIT系统以及之前的综述，排除了放射学计算机辅助诊断、监测警报和警报，以及专注于疾病分期和预后的研究。在诊断过程的概念框架内组织了文章，并确定了需要进一步调查的领域。HIT方法、工具和算法被确定并组织成与协助者有关的10个类别：(1)信息收集；(2)信息组织和显示；(3)鉴别诊断生成；(4)诊断权重；(5)诊断计划生成；(6)获取诊断参考信息；(7)促进随访；(8)筛查无症状患者的早期发现；(9)协作诊断；以及(10)促进对临床医生的诊断反馈。我们发现了许多描述潜在干预措施的研究，但在实际临床环境中评估干预措施的相对较少，证明临床影响的研究更少。诊断性HIT研究仍处于早期阶段，几乎没有可测量的临床影响的证据。未来的努力需要集中在：(1)改进使用电子数据衡量诊断过程的方法和标准；(2)电子健康记录中更好的可用性和界面；(3)在临床工作流程中更有意义地纳入循证诊断协议；以及(4)诊断业绩的系统反馈。
Health information technology (HIT) systems have the potential to reduce delayed, missed or incorrect diagnoses. We describe and classify the current state of diagnostic HIT and identify future research directions. A multi-pronged literature search was conducted using PubMed, Web of Science, backwards and forwards reference searches and contributions from domain experts. We included HIT systems evaluated in clinical and experimental settings as well as previous reviews, and excluded radiology computer-aided diagnosis, monitor alerts and alarms, and studies focused on disease staging and prognosis. Articles were organised within a conceptual framework of the diagnostic process and areas requiring further investigation were identified. HIT approaches, tools and algorithms were identified and organised into 10 categories related to those assisting: (1) information gathering; (2) information organisation and display; (3) differential diagnosis generation; (4) weighing of diagnoses; (5) generation of diagnostic plan; (6) access to diagnostic reference information; (7) facilitating follow-up; (8) screening for early detection in asymptomatic patients; (9) collaborative diagnosis; and (10) facilitating diagnostic feedback to clinicians. We found many studies characterising potential interventions, but relatively few evaluating the interventions in actual clinical settings and even fewer demonstrating clinical impact. Diagnostic HIT research is still in its early stages with few demonstrations of measurable clinical impact. Future efforts need to focus on: (1) improving methods and criteria for measurement of the diagnostic process using electronic data; (2) better usability and interfaces in electronic health records; (3) more meaningful incorporation of evidence-based diagnostic protocols within clinical workflows; and (4) systematic feedback of diagnostic performance.
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影响因子：
7.4
作者：
Croskerry, Pat
通讯作者：
Croskerry, Pat
影响因子：
6.2
作者：
Baxt, WG;Shofer, FS;Hollander, JE
通讯作者：
Hollander, JE
影响因子：
4.7
作者：
Armstrong, April W.;Kwong, Mei W.;Shewry, Sandra Louise
通讯作者：
Shewry, Sandra Louise
DOI：
10.1016/j.ijmedinf.2006.01.006
发表时间：
2007-04-01
影响因子：
4.9
作者：
Benaroia, Mark;Elinson, Roman;Zarnke, Kelly
通讯作者：
Zarnke, Kelly
影响因子：
8.9
作者：
Adamson, Steven C.;Bachman, John W.
通讯作者：
Bachman, John W.