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Evidence-based guidelines and decision support services: a discussion and evaluation in triple assessment of suspected breast cancer

Widespread health service goals to improve consistency and safety in patient care have prompted considerable investment in the development of evidence-based clinical guidelines. Computerised decision support (CDS) systems have been proposed as a means to implement guidelines in practice. This paper...

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Autores principales: Patkar, V, Hurt, C, Steele, R, Love, S, Purushotham, A, Williams, M, Thomson, R, Fox, J
Formato: Texto
Lenguaje:English
Publicado: Nature Publishing Group 2006
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2360742/
https://www.ncbi.nlm.nih.gov/pubmed/17117181
http://dx.doi.org/10.1038/sj.bjc.6603470
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author Patkar, V
Hurt, C
Steele, R
Love, S
Purushotham, A
Williams, M
Thomson, R
Fox, J
author_facet Patkar, V
Hurt, C
Steele, R
Love, S
Purushotham, A
Williams, M
Thomson, R
Fox, J
author_sort Patkar, V
collection PubMed
description Widespread health service goals to improve consistency and safety in patient care have prompted considerable investment in the development of evidence-based clinical guidelines. Computerised decision support (CDS) systems have been proposed as a means to implement guidelines in practice. This paper discusses the general concept in oncology and presents an evaluation of a CDS system to support triple assessment (TA) in breast cancer care. Balanced-block crossover experiment and questionnaire study. One stop clinic for symptomatic breast patients. Twenty-four practising breast clinicians from United Kingdom National Health Service hospitals. A web-based CDS system. Clinicians made significantly more deviations from guideline recommendations without decision support (60 out of 120 errors without CDS; 16 out of 120 errors with CDS, P<0.001). Ignoring minor deviations, 16 potentially critical errors arose in the no-decision-support arm of the trial compared with just one (P=0.001) when decision support was available. Opinions of participating clinicians towards the CDS tool became more positive after they had used it (P<0.025). The use of decision support capabilities in TA may yield significant measurable benefits for quality and safety of patient care. This is an important option for improving compliance with evidence-based practice guidelines.
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spelling pubmed-23607422009-09-10 Evidence-based guidelines and decision support services: a discussion and evaluation in triple assessment of suspected breast cancer Patkar, V Hurt, C Steele, R Love, S Purushotham, A Williams, M Thomson, R Fox, J Br J Cancer Clinical Study Widespread health service goals to improve consistency and safety in patient care have prompted considerable investment in the development of evidence-based clinical guidelines. Computerised decision support (CDS) systems have been proposed as a means to implement guidelines in practice. This paper discusses the general concept in oncology and presents an evaluation of a CDS system to support triple assessment (TA) in breast cancer care. Balanced-block crossover experiment and questionnaire study. One stop clinic for symptomatic breast patients. Twenty-four practising breast clinicians from United Kingdom National Health Service hospitals. A web-based CDS system. Clinicians made significantly more deviations from guideline recommendations without decision support (60 out of 120 errors without CDS; 16 out of 120 errors with CDS, P<0.001). Ignoring minor deviations, 16 potentially critical errors arose in the no-decision-support arm of the trial compared with just one (P=0.001) when decision support was available. Opinions of participating clinicians towards the CDS tool became more positive after they had used it (P<0.025). The use of decision support capabilities in TA may yield significant measurable benefits for quality and safety of patient care. This is an important option for improving compliance with evidence-based practice guidelines. Nature Publishing Group 2006-12-04 2006-11-21 /pmc/articles/PMC2360742/ /pubmed/17117181 http://dx.doi.org/10.1038/sj.bjc.6603470 Text en Copyright © 2006 Cancer Research UK https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material.If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/.
spellingShingle Clinical Study
Patkar, V
Hurt, C
Steele, R
Love, S
Purushotham, A
Williams, M
Thomson, R
Fox, J
Evidence-based guidelines and decision support services: a discussion and evaluation in triple assessment of suspected breast cancer
title Evidence-based guidelines and decision support services: a discussion and evaluation in triple assessment of suspected breast cancer
title_full Evidence-based guidelines and decision support services: a discussion and evaluation in triple assessment of suspected breast cancer
title_fullStr Evidence-based guidelines and decision support services: a discussion and evaluation in triple assessment of suspected breast cancer
title_full_unstemmed Evidence-based guidelines and decision support services: a discussion and evaluation in triple assessment of suspected breast cancer
title_short Evidence-based guidelines and decision support services: a discussion and evaluation in triple assessment of suspected breast cancer
title_sort evidence-based guidelines and decision support services: a discussion and evaluation in triple assessment of suspected breast cancer
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2360742/
https://www.ncbi.nlm.nih.gov/pubmed/17117181
http://dx.doi.org/10.1038/sj.bjc.6603470
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