@Article{信息:doi 10.2196 / / jmir。3228，作者=“陈鹏莱、柴鹏莱、程静、李静、谢凯春、梁少玉、韩、沈、冯兴荣、瑞、王德斌”，标题=“中国农村预防糖尿病的智能网络辅助:初步发现与教训”，期刊=“J医学互联网研究”，年=“2014”，月=“4”，日=“01”，卷=“16”，数=“4”，页数=“e98”，关键词=“糖尿病;前驱糖尿病的状态;互联网;预防;评估;背景:糖尿病病例的增加，常规操作预防的普遍缺乏，以及长期将疾病预防和治疗分开的历史，都要求前沿临床医生立即参与。这尤其适用于在中国农村工作的乡村医生，中国绝大多数人口都生活在农村。目的:本研究旨在开发和测试一种预防2型糖尿病的在线智能网络辅助工具(SWAP-DM2)，能够解决应用有效干预措施和将糖尿病预防纳入常规医疗护理的主要障碍。方法:采用进化原型技术开发SWAP-DM2。 The design of the initial system was followed by refinement cycles featuring dynamic interaction between development of practical and effective standardized operation procedures (SOPs) for diabetes prevention and Web-based assistance for implementing the SOPs. The resulting SOPs incorporated proven diabetes prevention practices in a synergetic way. SWAP-DM2 provided support to village doctors ranging from simple educational webpages and record maintenance to relatively sophisticated risk scoring and personalized counseling. Evaluation of SWAP-DM2 used data collected at baseline and 6-month follow-up assessment: (1) audio recordings of service encounters; (2) structured exit surveys of patients' knowledge, self-efficacy, and satisfaction; (3) measurement of fasting glucose, body mass index, and blood pressure; and (4) qualitative interviews with doctors and patients. Data analysis included (1) descriptive statistics of patients who received SWAP-DM2--assisted prevention and those newly diagnosed with prediabetes and diabetes; (2) comparison of the variables assessed between baseline and follow-up assessment; and (3) narratives of qualitative data. Results: The 17 participating village doctors identified 2219 patients with elevated diabetes risk. Of these, 84.85{\%} (1885/2219) consented to a fasting glucose test with 1022 new prediabetes and 113 new diabetes diagnoses made within 6 months. The prediabetic patients showed substantial improvement from baseline to 6-month follow-up in vegetable intake (17.0{\%}, 43/253 vs 88.7{\%}, 205/231), calorie intake (1.6{\%}, 4/253 vs 71.4{\%}, 165/231), leisure-time exercises (6.3{\%}, 16/253 vs 21.2{\%}, 49/231), body weight (mean 62.12 kg, SD 9.85 vs mean 58.33 kg, SD 9.18), and body mass index (mean 24.80 kg/m2, SD 3.21 vs mean 23.36 kg/m2, SD 2.95). The prediabetic patients showed improvement in self-efficacy for modifying diet (mean 5.31, SD 2.81 vs mean 8.53, SD 2.25), increasing physical activities (mean 4.52, SD 3.35 vs mean 8.06, SD 2.38), engaging relatives (mean 3.93, SD 3.54 vs mean 6.93, SD 2.67), and knowledge about diabetes and risks of an imbalanced diet and inadequate physical activity. Most participating doctors and patients viewed SWAP-DM2 as useful and effective. Conclusions: SWAP-DM2 is helpful to village doctors, acceptable to patients, and effective in modifying immediate determinants of diabetes at least in the short term, and may provide a useful solution to the general lack of participation in diabetes prevention by frontier clinicians in rural China. Trial Registration: International Standard Randomized Controlled Trial Number (ISRCTN): 66772711; http://www.controlled-trials.com/ISRCTN66772711 (Archived by WebCite at http://www.webcitation.org/6OMkAqyEy). ", issn="14388871", doi="10.2196/jmir.3228", url="//www.mybigtv.com/2014/4/e98/", url="https://doi.org/10.2196/jmir.3228", url="http://www.ncbi.nlm.nih.gov/pubmed/24691410" }