%0期刊文章%@ 1438-8871 %I Gunther Eysenbach %V 5% N 2% P e 12% T使用万维网实施临床实践指南:可行性研究%A Jeannot,Jean-Gabriel %A Scherer,Frédy %A Pittet,Valérie %A Burnand,Bernard %A Vader,John-Paul %+社会和预防医学研究所，医学信息学，电子咨询中心，Hôpital des Cadolles, 1005洛桑，2000 Neuchâtel，瑞士，+ 41 32 722 91 09,jeannot@ne.ch %K实践指南%K互联网%K决策支持系统，临床%K护理适当性%K保健质量%K背痛%K椎板切除术%K内镜%D 2003 %7 13.6.2003 %9原始论文%J J医学互联网Res %G英文%X背景:过去几年在制定高质量临床指南方面投入了重要的努力。然而，向执业医师有效传播指南的方法尚未确定。一些研究已经检验了万维网(Web)提供的可能性，但是在实际实践中检验临床指南实施的研究显然缺乏。目的:本研究评估了网络在实际临床环境中实施临床实践指南的潜力。它还记录了医生在使用互联网指南时所感受到的障碍，以确定Web在实践指南实施中可以发挥的作用。方法:使用标准化的面板方法制定了两项指南，并通过Web提供。一个涉及下背部手术的适应症，另一个涉及上、下消化道内窥镜检查的适应症。为了确定在临床实践中使用它们的障碍，要求20名医生在与患者会诊时参考指南。 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. %M 12857668 %R 10.2196/jmir.5.2.e12 %U //www.mybigtv.com/2003/2/e12/ %U https://doi.org/10.2196/jmir.5.2.e12 %U http://www.ncbi.nlm.nih.gov/pubmed/12857668