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Electronic Consultation Support System for Radiocontrast Media Hypersensitivity Changes Clinicians' Behavior

机译:造影剂超敏反应的电子咨询支持系统改变了医生的行为

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Purpose Patients with a history of radiocontrast media (RCM) hypersensitivity can be overlooked, resulting in repeated reactions. Therefore, a consultation support system for RCM hypersensitivity has been in operation at Seoul National University Bundang Hospital since December 2011. We analyzed the effect of this system on physicians' practice. Methods A retrospective study was conducted on patients with previous RCM reactions (December 1, 2010 to November 30, 2012). The control period was December 2010 to November 2011, and the intervention period was December 2011 to November 2012. The primary outcome was the composite outcome of premedication and consultation. Premedication was defined as preventive medication prescribed by the physician who ordered RCM-enhanced computed tomography (CT) at the same time. The secondary outcome was the recurrence rate after using the consultation support system. Results A total of 189 clinicians prescribed 913 CT scans during the control period and 225 clinicians performed 1,153 examinations during the intervention period. The odds ratio (OR) of achieving the composite outcome increased significantly after use of the consultation support system (OR, 1.54; 95% confidence interval [CI], 1.15–2.05). Clinicians in both medical (OR, 1.48; 95% CI, 1.06–2.07) and surgical (OR, 2.07; 95% CI, 1.24–3.46) departments showed significant changes in their behavior, whereas those in the emergency department did not (OR, 1.07; 95% CI, 0.41–2.78). Professors (OR, 1.47; 95% CI, 1.06–2.04) and trainees (OR, 1.97, 95% CI, 1.22–3.18) showed significant changes in their behavior toward patients with previous RCM reactions. The behavior of 86 clinicians who ordered CT scans during both the control and intervention periods was unchanged. Conclusions The consultation support system for those with previous RCM hypersensitivity reactions changed physicians' practice patterns and decreased recurrent RCM hypersensitivity reactions as well.
机译:目的可以忽略有放射性造影剂(RCM)过敏史的患者,从而导致反复反应。因此,自2011年12月起,首尔国立大学盆唐医院就开始实施RCM过敏症咨询支持系统。我们分析了该系统对医师实践的影响。方法对2010年12月1日至2012年11月30日以前有RCM反应的患者进行回顾性研究。控制期为2010年12月至2011年11月,干预期为2011年12月至2012年11月。主要结局是用药和咨询的综合结果。处方药的定义是由同时订购RCM增强型计算机体层摄影(CT)的医师开具的预防性药物。次要结果是使用咨询支持系统后的复发率。结果在控制期间,共有189名临床医生开出913项CT扫描,在干预期间有225名临床医生进行了1,153项检查。使用咨询支持系统后,达到综合结果的比值比(OR)显着增加(OR,1.54; 95%置信区间[CI],1.15–2.05)。内科(OR,1.48; 95%CI,1.06-2.07)和外科(OR,2.07; 95%CI,1.24–3.46)的临床医生的行为都有显着变化,而急诊科的医生则没有(OR ,1.07; 95%CI,0.41-2.78)。教授(OR,1.47; 95%CI,1.06-2.04)和受训者(OR,1.97,95%CI,1.22-3.18)显示,他们对先前有RCM反应的患者的行为发生了重大变化。在对照和干预期间,下令进行CT扫描的86位临床医生的行为没有改变。结论先前有RCM过敏反应的患者的咨询支持系统改变了医生的实践方式,并减少了RCM过敏反应的复发。

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