@文章{信息:doi/10.2196/36976，作者=“Silvestri, Jasmine A和Kmiec, Tyler E和Bishop, Nicholas S和Regli, Susan H和Weissman, Gary E”，标题=“早期脓毒症识别临床决策支持系统的期望特征:医院临床医生的访谈研究”，期刊=“JMIR Hum Factors”，年=“2022”，月=“10月”，日=“21”，卷=“9”，数=“4”，页=“e36976”，关键词=“脓毒症;预测信息;临床决策支持;人为因素;背景:败血症是美国卫生保健系统的主要负担，每年有超过75万例病例，总费用约为200亿美元。脓毒症治疗的标志是及早和适当地开始抗生素治疗。尽管脓毒症临床决策支持(CDS)系统可以为临床医生提供疑似脓毒症或即将到来的临床衰退的早期预测，但此类系统尚未可靠地证明临床结果或护理过程的改善。越来越多的证据表明，将脓毒症CDS系统集成到临床工作流程中，获得临床医生的信任，以及使脓毒症CDS系统在床边具有临床相关性，这些挑战都是成功部署的障碍。然而，在实现这些实现和部署目标方面存在着重大的知识差距。目的:我们的目的是根据临床医生过去的经验确定对脓毒症CDS系统预测信息的看法，探索临床医生对假设的脓毒症CDS系统的看法，并确定CDS系统的特征，这将有助于在多学科、基于团队的临床环境中促进对疑似脓毒症的及时识别和管理。 Methods: We conducted semistructured interviews with practicing bedside nurses, advanced practice providers, and physicians at a large academic medical center between September 2020 and March 2021. We used modified human factor methods (contextual interview and cognitive walkthrough performed over video calls because of the COVID-19 pandemic) and conducted a thematic analysis using an abductive approach for coding to identify important patterns and concepts in the interview transcripts. Results: We interviewed 6 bedside nurses and 9 clinicians responsible for ordering antibiotics (advanced practice providers or physicians) who had a median of 4 (IQR 4-6.5) years of experience working in an inpatient setting. We then synthesized critical content from the thematic analysis of the data into four domains: clinician perceptions of prediction models and alerts; previous experiences of clinician encounters with predictive information and risk scores; desired characteristics of a CDS system build, including predictions, supporting information, and delivery methods for a potential alert; and the clinical relevance and potential utility of a CDS system. These 4 domains were strongly linked to clinicians' perceptions of the likelihood of adoption and the impact on clinical workflows when diagnosing and managing patients with suspected sepsis. Ultimately, clinicians desired a trusted and actionable CDS system to improve sepsis care. Conclusions: Building a trusted and actionable sepsis CDS alert is paramount to achieving acceptability and use among clinicians. These findings can inform the development, implementation, and deployment strategies for CDS systems that support the early detection and treatment of sepsis. This study also highlights several key opportunities when eliciting clinician input before the development and deployment of prediction models. ", issn="2292-9495", doi="10.2196/36976", url="https://humanfactors.www.mybigtv.com/2022/4/e36976", url="https://doi.org/10.2196/36976", url="http://www.ncbi.nlm.nih.gov/pubmed/36269653" }