AMIA Annu Symp Proc - Role of physicians' reactance in e-iatrogenesis: a case study with ASTI guiding mode on the management of hypertension.

Tópicos

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Resumo

Clinical decision support systems (CDSSs) have the potential to increase guideline adherence, but factors of success are not yet understood. ASTI guiding mode (ASTI-GM) is an on-demand guideline-based CDSS where the user navigates in a knowledge base to get the best treatment for a given patient. We conducted a web-based evaluation of ASTI-GM, carried out as a before-after study, where general practitioners (GPs) were asked to solve 5 clinical cases, first without ASTI-GM, then using the system. Of the 136 GPs that resolved the case on the management of hypertension, compliance with best practices increased from 69.1% to 80.9% with ASTI-GM. When the navigation matched the set of patient parameters described in the clinical case, the increase was even higher and reached 92.9%. E-iatrogenesis has been measured at 19.1%, with 5.1% of commission errors, 8.1% of negative reactance, and 5.9% of neutral reactance. Role of physicians' reactance in noncompliance with guideline-based CDSSs should be further investigated.

Resumo Limpo

clinic decis support system cdsss potenti increas guidelin adher factor success yet understood asti guid mode astigm ondemand guidelinebas cdss user navig knowledg base get best treatment given patient conduct webbas evalu astigm carri beforeaft studi general practition gps ask solv clinic case first without astigm use system gps resolv case manag hypertens complianc best practic increas astigm navig match set patient paramet describ clinic case increas even higher reach eiatrogenesi measur commiss error negat reactanc neutral reactanc role physician reactanc noncompli guidelinebas cdsss investig

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