Evidence Based Decision Making: Integrating Clinical Prediction Rules into Electr

基于证据的决策：将临床预测规则集成到 Electr 中

基本信息

批准号：
8080374
负责人：
THOMAS G MCGINN
金额：
$ 30.95万
依托单位：
FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-30 至 2013-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8080374
关键词：
Evidence Based Decision Making Integrating

项目摘要

DESCRIPTION (provided by applicant): Clinical prediction rules (CPRs) are frontline decision aids that help physicians make evidence-based, cost effective decisions that benefit their patients. CPRs are proven tools that translate evidence into practice, increase quality while reducing costs, and can be used by physicians in a wide variety of clinical settings, such as primary care offices, emergency rooms, and hospitals. While many CPRs have been developed and validated over the years, health care providers have yet to incorporate them into everyday care. CPRs aid providers in assessing the impact of individual components of a patient's history, physical examination, and basic lab results to estimate probability of disease or potential response to a treatment. Prediction rules use data that is readily available at the time of a patient encounter and often reduce unnecessary treatments and diagnostic testing. CPRs differ from reminder systems or alerts in that CPRs pull in aspects of the history and physical exam and in an evidence based fashion estimate probabilities, prognosis, or make treatment recommendations. The goal of this study is to utilize patient electronic health records to incorporate CPRs into the face-to-face patient encounter. We propose to select certain clinical situations where well-validated CPRs are available and likely to be needed on a frequent basis. We will randomly assign an integrated CPR versus usual care into the point of care and evaluate the impact of this integration on doctor behavior and evidence-based decision making. Mount Sinai's Division of General Internal Medicine (DGIM) has significant experience with all aspects of CPRs, including derivation, validation, implementation, and systematic review. Furthermore, the Division has developed an interactive web library of CPRs for clinical use that is one of the most widely sites of its kind. We propose to collaborate with Epic, one of the nation's largest and most respected electronic medical record (EMR) companies, to integrate validated CPRs into EMRs and assess the impact on provider behavior and patient care.

描述（由申请人提供）：临床预测规则（CPRS）是一线决策辅助工具，可帮助医生做出基于证据的，具有成本效益的决策，从而使患者受益。 CPR是经过验证的工具，可以将证据转化为实践，提高质量同时降低成本，并且可以在各种临床环境（例如初级保健办公室，急诊室和医院）中使用。尽管多年来已经开发和验证了许多CPR，但医疗保健提供者尚未将其纳入日常护理。 CPRS帮助提供者评估患者病史的各个组成部分，体格检查和基本实验室结果的影响，以估计疾病的可能性或对治疗的潜在反应。预测规则使用患者遇到时随时可用的数据，并且通常会减少不必要的治疗和诊断测试。 CPR与提醒系统或警报不同，因为CPR在历史和身体检查方面都吸引了，并且在基于证据的时尚估计概率，预后，预后，或提出治疗建议。这项研究的目的是利用患者电子健康记录将CPR纳入面对面的患者遇到。我们建议选择某些临床情况，在这些情况下，可以频繁地使用验证良好的CPR并可能需要。我们将随机将综合性心肺复苏术与通常的护理分配到护理点，并评估这种整合对医生行为和基于证据的决策的影响。西奈山（Mount Sinai）的通用内科（DGIM）在CPR的各个方面都有丰富的经验，包括推导，验证，实施和系统审查。此外，该部门开发了一个互动的CPR库，用于临床用途，这是同类网站上最广泛的网站之一。我们建议与美国最大，最受人尊敬的电子病历（EMR）公司之一Epic合作，以将经过验证的CPR整合到EMR中，并评估对提供者行为和患者护理的影响。