临床药师抗感染会诊辅助决策系统的开发与实证评价研究

细菌耐药已成为全球严重的公共卫生问题，临床药师抗感染会诊在“全国抗菌药物专项整治行动”中得以不断推进。前期研究证实，临床药师会诊干预在感染性疾病治疗中的发挥了重要作用。但是基层医疗机构临床药师会诊水平参差不齐，不能满足抗感染会诊的要求。因此，标准化临床药师抗感染会诊是提升会诊服务质量的关键，但目前国内外尚无统一的实践指南可参考。据此本项目基于我院的会诊模式，通过经典的定性和定量研究方法，综合采用知识图谱、大数据挖掘和自然语言处理等人工智能技术，开发临床药师抗感染会诊辅助决策系统；并开展多中心时效性随机对照试验评价该系统在实践中的效果。本项目立足于医改与“健康中国2030”合理用药的目标，以抗感染会诊为切入点，开发了临床药师会诊辅助决策系统，对提升基层医疗机构临床药师会诊水平，规范会诊流程，提高感染性疾病治疗效果，促进抗菌药物合理使用有示范带动价值，可供其他疾病领域的临床药学实践借鉴。

At present, bacterial resistance to antibiotics has become a global issue of public health. In the context of Antimicrobial Stewardship Program, clinical pharmacist-led consultation was gradually developed in China. Previous studies demonstrated the essential role of the consultation intervention in the management of rational use of antimicrobial drug and in the treatment of infectious diseases. Nevertheless, resource in clinical pharmacist is poor in primary medical institutions, therefore unable to satisfy the requirements of anti-infection consultation. To address this issue, we believe the key point is to standardize the consultation service. Nevertheless, neither practical guideline with consensus nor standardized procedure is available no matter in domestic or abroad. Therefore, this project aims to develop a clinical decision support system for anti-infection consultation on the basis of the consultation mode of our institution by classical qualitative and quantitative research methods and artificial intelligence technology (e.g. knowledge graph, data mining, natural language processing, etc.). The effectiveness of this system is further evaluated in a multicenter, pragmatic randomized controlled trial. As a pioneering research which develops a clinical decision support system for clinical pharmacist-led consultation, this project will conform to the goals of Medicare Reform and ‘Healthy China 2030’, and focus on the treatment of infectious diseases. This research can help enhance the skills and capabilities of consultation for clinical pharmacists in primary medical institutions, standardize the procedure of consultation, improve the outcome of patients with infectious diseases, and promote rational use of antibiotics. Furthermore, this study can serve as a reference for clinical pharmaceutical service in other disease area.