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首页> 外文期刊>BMC Medical Informatics and Decision Making >A computer decision aid for medical prevention: a pilot qualitative study of the Personalized Estimate of Risks (EsPeR) system
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A computer decision aid for medical prevention: a pilot qualitative study of the Personalized Estimate of Risks (EsPeR) system

机译：用于医疗预防的计算机决策辅助工具：个性化风险评估（EsPeR）系统的定性试验研究

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Background Many preventable diseases such as ischemic heart diseases and breast cancer prevail at a large scale in the general population. Computerized decision support systems are one of the solutions for improving the quality of prevention strategies. Methods The system called EsPeR (Personalised Estimate of Risks) combines calculation of several risks with computerisation of guidelines (cardiovascular prevention, screening for breast cancer, colorectal cancer, uterine cervix cancer, and prostate cancer, diagnosis of depression and suicide risk). We present a qualitative evaluation of its ergonomics, as well as it's understanding and acceptance by a group of general practitioners. We organised four focus groups each including 6–11 general practitioners. Physicians worked on several structured clinical scenari os with the help of EsPeR, and three senior investigators leaded structured discussion sessions. Results The initial sessions identified several ergonomic flaws of the system that were easily corrected. Both clinical scenarios and discussion sessions identified several problems related to the insufficient comprehension (expression of risks, definition of familial history of disease), and difficulty for the physicians to accept some of the recommendations. Conclusion Educational, socio-professional and organisational components (i.e. time constraints for training and use of the EsPeR system during consultation) as well as acceptance of evidence-based decision-making should be taken into account before launching computerised decision support systems, or their application in randomised trials.
机译：背景技术许多可预防的疾病，例如缺血性心脏病和乳腺癌在大规模人群中普遍存在。计算机决策支持系统是提高预防策略质量的解决方案之一。方法名为EsPeR（风险的个性化估计）的系统将几种风险的计算与准则的计算机化（心血管疾病预防，乳腺癌筛查，大肠癌，子宫颈癌和前列腺癌，抑郁症和自杀风险的诊断）结合起来。我们对它的人体工程学进行了定性评估，并得到了一组全科医生的理解和接受。我们组织了四个焦点小组，每个小组包括6-11名全科医生。在EsPeR的帮助下，医师们进行了几种结构化的临床研究，由三名高级研究人员主持了结构化的讨论会。结果最初的会议确定了该系统的一些人体工程学缺陷，可以轻松纠正。临床方案和讨论会都确定了与理解不足（风险的表达，疾病的家族史的定义）以及医师难以接受某些建议有关的几个问题。结论在启动计算机化决策支持系统或其应用之前，应考虑到教育，社会专业和组织组成部分（即培训期间在培训和使用EsPeR系统方面的时间限制）以及接受基于证据的决策在随机试验中。

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