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实践中的计算机决策支持系统。

Computer decision support systems (CDS) can increase the uptake of guidelines by physicians.
Data represented by 3-D coloured lights in yellow, green and blue
© UoD 和 BSAC

计算机决策支持系统 (CDS) 可增进医生对指导原则的理解。

但是,它们很难实施,在实施和维护中需要大量资源,医生的理解通常欠佳。

集成到电子健康记录和计算机处方录入 (CPOE) 中时,CDS 的用处可能最大。理想情况下,CDS 算法会考虑个体患者信息(例如,微生物学数据、体重、肾功能、合并用药、合并症等)和流行病学数据(例如,机构或病房特异性抗菌谱),引导处方人员根据抗生素选择、给药方式和持续时间选择最佳抗生素疗法,并指定适当的微生物学和成像测试。

在实践中,个体患者信息的融合很难实现,因为数据库可能不太容易链接或数据可能未按标准术语编码(例如,如果没有将术语“S. aureus”“Staphylcococus aureus”“Staph. aureus”、“MSSA”等识别为相同概念的清晰编码,则将难以使用微生物数据)

用户友好性、功能以及无缝集成到临床工作流程可能也是成功实施 CDS 的关键。CDS 系统的任何“警示”都应有较高的阳性预测值(即,极少虚假报警),以避免“警示疲劳”并在随后忽视处方人员的警示。

总的来说,CDS 系统目前仍面临巨大障碍。由于普遍采用电子健康记录且医疗点的电子设备可用性一直在提高,因此 CDS 系统仍然有望成为未来抗生素管理的关键支柱。

© UoD 和 BSAC
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抗菌素管理: 管理抗生素耐药性

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