Computer support for interpreting family histories of breast and ovarian cancer in primary care: comparative study with simulated cases
| Autor: | Jon Emery, Cyril Chapman, John Fox, David Glasspool, Andrew Coulson, Pat Yudkin, Michael Murphy, Joan Austoker, Robert Walton |
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| Jazyk: | angličtina |
| Rok vydání: | 2000 |
| Předmět: |
Male
medicine.medical_specialty Decision support system Information in Practice Psychological intervention MEDLINE Breast Neoplasms Pilot Projects Medicine Humans Risk factor Family history Decision Making Computer-Assisted General Environmental Science Ovarian Neoplasms Cross-Over Studies business.industry Specific-information General Engineering General Medicine Prognosis Confidence interval Surgery Pedigree Patient Simulation Family medicine General Earth and Planetary Sciences Female business Risk assessment Family Practice |
| Popis: | OBJECTIVES: To evaluate the potential effect of computer support on general practitioners' management of familial breast and ovarian cancer, and to compare the effectiveness of two different types of computer program. DESIGN: Crossover experiment with balanced block design. PARTICIPANTS: Of a random sample of 100 general practitioners from Buckinghamshire who were invited, 41 agreed to participate. From these, 36 were selected for a fully balanced study. INTERVENTIONS: Doctors managed 18 simulated cases: 6 with computerised decision support system Risk Assessment in Genetics (RAGs), 6 with Cyrillic (an established pedigree drawing program designed for clinical geneticists), and 6 with pen and paper. MAIN OUTCOME MEASURES: Number of appropriate management decisions made (maximum 6), mean time taken to reach a decision, number of pedigrees accurately drawn (maximum 6). Secondary measures were method of support preferred for particular aspects of managing family histories of cancer; importance of specific information on cancer genetics that might be provided by an "ideal computer program." RESULTS: RAGs resulted in significantly more appropriate management decisions (median 6) than either Cyrillic (median 3) or pen and paper (median 3); median difference between RAGs and Cyrillic 2.5 (95% confidence interval 2.0 to 3.0; P |
| Databáze: | OpenAIRE |
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