面向初级保健临床医生的哮喘诊断临床决策支持系统的使用和可接受性:一项观察性混合方法研究。

IF 3.1 3区 医学 Q1 PRIMARY HEALTH CARE NPJ Primary Care Respiratory Medicine Pub Date : 2024-11-27 DOI:10.1038/s41533-024-00401-x
Luke Daines, Anne Canny, Eddie Donaghy, Victoria Murray, Leo Campbell, Carol Stonham, Heather Milne, David Price, Mark Buchner, Lesley Nelson, Frances S Mair, Aziz Sheikh, Andrew Bush, Brian McKinstry, Hilary Pinnock
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引用次数: 0

摘要

哮喘的最佳诊断方法尚不确定,尤其是在基层医疗机构,误诊很常见。为此,我们开发了一套临床决策支持系统(CDSS),用于儿童和青少年(5-25 岁)的哮喘诊断。本研究探讨了 CDSS 在英国初级医疗中的可行性和可接受性。我们招募了英格兰和苏格兰的全科医生。CDSS 可在常规咨询中使用,为期 6 个月。我们分析了 CDSS 的使用情况,并在研究接近尾声时对使用过 CDSS 的临床医生进行了定性访谈。在完成研究的 10 家诊所中,94 名临床医生中有 75 名使用了 CDSS。来自 8 家诊所的 11 名临床医生接受了访谈。参与者对 CDSS 的易用性和从病历中自动填充信息给予了高度评价。使用障碍包括无法将检查结果直接记录到病历中,以及虽然 CDSS 可能对实习生和初级同事有用,但不一定会导致他们改变自己的做法。CDSS 普遍受到初级保健临床医生的欢迎,但参与者认为它对实习生和经验较少的同事最有用。
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Use and acceptability of an asthma diagnosis clinical decision support system for primary care clinicians: an observational mixed methods study.

There is uncertainty about how best to diagnose asthma, especially in primary care where mis-diagnosis is common. To address this, we developed a clinical decision support system (CDSS) for asthma diagnosis in children and young people (aged 5-25 years). This study explored the feasibility and acceptability of the CDSS in UK primary care. We recruited general practices from England and Scotland. The CDSS was available for use during routine consultations for six months. We analysed CDSS usage and, toward the end of the study, undertook qualitative interviews with clinicians who had used the CDSS. Within the 10 practices who completed the study, the CDSS was used by 75 out of 94 clinicians. 11 clinicians from 8 practices were interviewed. The CDSS was acceptable to participants who particularly commented on the ease of use and auto-population of information from the patient record. Barriers to use included the inability to record findings directly into the patient notes and a sense that, whilst possibly useful for trainees and junior colleagues, the CDSS would not necessarily lead to a change in their own practice. The CDSS was generally well received by primary care clinicians, though participants felt it would be most useful for trainees and less experienced colleagues.

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来源期刊
NPJ Primary Care Respiratory Medicine
NPJ Primary Care Respiratory Medicine PRIMARY HEALTH CARE-RESPIRATORY SYSTEM
CiteScore
5.50
自引率
6.50%
发文量
49
审稿时长
10 weeks
期刊介绍: npj Primary Care Respiratory Medicine is an open access, online-only, multidisciplinary journal dedicated to publishing high-quality research in all areas of the primary care management of respiratory and respiratory-related allergic diseases. Papers published by the journal represent important advances of significance to specialists within the fields of primary care and respiratory medicine. We are particularly interested in receiving papers in relation to the following aspects of respiratory medicine, respiratory-related allergic diseases and tobacco control: epidemiology prevention clinical care service delivery and organisation of healthcare (including implementation science) global health.
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