結合臨床診療指引與實證醫學之電腦化指引系統

A Computerize Guideline System by Integrating Clinical Practice Guidelines and Evidence-Based Medicines

楊雯雯(Wen-Wen Yang)

指導教授 ： 蔣以仁

臺北醫學大學/醫學院/醫學資訊研究所/碩士(2005年)

摘要

實證為基礎的臨床診療指引，可以幫助醫師在照護病患時做正確、適當的決策已是無庸置疑，世界各地紛紛卯足了勁在發展高品質的臨床診療指引， 但學者同時也發現繁忙的臨床醫師，接受指引並依據指引建議運用在臨床的問題的動機並不高，追究原因經常是源於無法適時適地的參考臨床診療指引。 本研究嘗試發展結合診療指引與實證醫學之電腦輔助臨床決策支援系統，將傳統紙本指引透過知識表示法編輯為電腦可譯的臨床診療指引，創新的運用知識地圖和主題地圖等視覺化方法，結合網際網路和爪哇語言的技術讓臨床診療指引可不受硬體或操作平台的限制，醫師可隨時隨地透過網際網路瀏覽所需的臨床指引，配合線上的實證文獻資料庫連結以協助醫療決策的判斷，達到知識互通共享的目的，同時亦減少診療指引重覆發展的成本浪費。

關鍵字

臨床診療指引 ； 實證醫學 ； 電腦可譯指引 ； 知識表示法 ； 視覺化 ； 知識地圖

並列摘要

Evidence-based clinical practice guideline (CPG) has been recognized as an important guidance to physicians for decision-making. These Guidelines can assist physicians in taking good clinical practices on their patients. Based on the overall healthcare improvements, the medical care quality can be reserved while practice discrepancy and errors being eliminated. Still, barriers exist in implementation, such as gaps, inconsistencies, and inertia associated with traditional practice behaviors. Moreover, other than these non-technical issues, clear representation and accessible guideline content at the point care are also critical. One way to easier implementation is through computerized and visualized guidelines combined with evidence-based literatures. Therefore, this paper presents a computer-interpretable guideline (CIG) system, EBCPG, which is composed of three main components: CPGs exploration, EBMs exploration and Web-based management to accommodate clinician decision-making and CIG maintainability. Two tasks based on CIGs exploration and visualization technologies are involved in facilitating the presentation of the CIG model. EBCPG provides a comprehensive way to assist clinicians in making decision according to the visualized clinical practice guidelines while encountering patients.

並列關鍵字

Clinical Practice Guideline ； Evidence-Based Medicine ； Computer-Interpretable Guideline ； Knowledge Representation ； Visualization

參考文獻

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