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张贝 (2023-05-31 22:23):
#paper Int J Med Inform. 2019 Oct;130:103940.  doi: 10.1016/j.ijmedinf.2019.07.019.Clinical decision support for therapeutic decision-making in cancer: A systematic review  包括支持性护理在内的癌症管理较为复杂,需要根据已发表的以及患者特异性数据做出适当的治疗决策。临床决策支持(CDS)或许是支持复杂决策的有效实施策略,尽管CDS是否能够改善治疗结局和患者结局尚不明确。因此,本文对CDS进行了系统回顾,以确定CDS用于支持临床癌症治疗决策。令人关注的结果包括CDS对诊疗过程的影响。10项研究符合纳入标准,研究设计、设置和干预存在差异。在衡量过程结局的九项研究中,有五项显示出显著的改善;在衡量患者结局的六项中,有四项显示出显著改善。所有纳入的研究都使用了临床实践指南提及的CDS。总之,CDS用于指导癌症治疗决策是一个尚待研究但很有前景的领域。
Abstract:
Cancer management, including supportive care, is complex and requires availability and synthesis of published and patient-specific data to make appropriate therapeutic decisions. Clinical decision support (CDS) may be an effective … >>>
Cancer management, including supportive care, is complex and requires availability and synthesis of published and patient-specific data to make appropriate therapeutic decisions. Clinical decision support (CDS) may be an effective implementation strategy to support complex decision making although it is unclear whether it improves process outcomes, patient outcomes or both in cancer settings. We therefore conducted a systematic review to identify CDS that have been used to support therapeutic decision making in clinical cancer settings. Outcomes of interest included the effect of CDS on the process, such as clinician's decision making and effect on patient outcomes. Ten studies met inclusion criteria, with variability in the study design, setting, and intervention. Of the nine studies that measured process outcomes, five demonstrated significant improvement; and of the six that measured patient outcomes, four demonstrated significant improvement. All included studies utilized CDS that were informed by clinical practice guidelines. In conclusion, CDS to guide cancer therapeutic decision making is an understudied but promising area. Further research is needed. <<<
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