@Article{信息:doi 10.2196 / / jmir.5.2。e12，作者="Jeannot, Jean-Gabriel and Scherer, Fr{\'e}dy and Pittet, Val{\'e}rie and Burnand, Bernard and Vader, John-Paul"，标题="利用万维网实施临床实践指南:可行性研究"，期刊="J Med Internet Res"，年="2003"，月="Jun"，日="13"，卷="5"，数="2"，页数="e12"，关键词="实践指南;互联网;临床决策支持系统;照顾的适当性;保健质量;背部疼痛;椎板切除术;背景:在过去的几年里，人们在制定高质量的临床指南方面投入了大量的努力。然而，向执业医师有效传播指南的方法尚未确定。 Several studies have examined the possibilities offered by the World Wide Web (the Web), but studies examining the implementation of clinical guidelines in actual practice are clearly lacking. Objective: This study assessed the potential of the Web to implement clinical practice guidelines in actual clinical settings. It also documents the obstacles perceived by the physicians in their use of guidelines on the Internet to determine the role that the Web can play in the implementation of guidelines in practice. Methods: Two guidelines were developed using a standardized panel method and made available via the Web. One concerned indications for low-back surgery and the other dealt with indications for upper and lower digestive endoscopies. To identify obstacles to their use in clinical practice, 20 physicians were asked to consult the guidelines during consultations with patients. Answers were collected using 3 different questionnaires. Results: Questionnaires were completed for consultations involving 213 patients. Less than 50{\%} of the physicians have direct access to the Internet in their examination room. For 75{\%}, the use of the guidelines was easy and the time required to consult them acceptable (3.4 minutes on average, or 12{\%} of the time spent with the patient). The fear that use of such guidelines might interfere with the physician-patient relationship was mentioned as a reason for not consulting the guidelines for 27 consultations. Taking into account their experience with the Web, 75{\%} of the physicians considered that the Web has a great or very-great potential for the dissemination of guidelines and 78{\%} indicated that they would use such guidelines if they became generally available for clinical questions that concerned them. Only 3 physicians had consulted guidelines on the Web prior to this study. Conclusions: The acceptance of use of clinical practice guidelines via the Web is high. The main limits to further use of such Web-based guidelines seem to be the lack of a computer connection in the physician's office or examining room and the fear that use of such guidelines might interfere with the physician-patient relationship. Though most participants appreciate the considerable potential of the Web for disseminating guidelines, only a small handful regularly use guidelines available on the Web. There are still numerous obstacles to the regular use of guidelines in clinical practice, some related to the physicians, others to the guidelines themselves. ", issn="1438-8871", doi="10.2196/jmir.5.2.e12", url="//www.mybigtv.com/2003/2/e12/", url="https://doi.org/10.2196/jmir.5.2.e12", url="http://www.ncbi.nlm.nih.gov/pubmed/12857668" }