PDF(Pubmed)
Abstract：
We performed a scoping review of informatics core literature about medical practice variation (MPV) as an agile summary of the subject in our field.
The Ovid integrated database was searched between 1946 and 2022 to identify MPV studies published in major informatics journals and conference proceedings. Two reviewers performed relevance screening, with assistance from another independent reviewer for adjudication. The included articles were then thematically analyzed and summarized through discussion among all three reviewers.
A total of 43 articles were included and went through the thematic analysis. About half (n = 21) of the included articles were published in conference proceedings. Five articles reported the effect of MPV on patient outcomes. The variation of interest was most frequently in treatment decisions. In terms of the role informatics played (multiple roles allowed), 39 (90.7%) articles pertained to detection of MPV, 5 were about prevention of MPV and 4 about learning from MPV.
MPV remains a critical issue in health care, yet most informatics research has been focused on simple tasks such as automating the detection of MPV and assessing compliance to decision-support systems, and less focused on addressing the causes of variation or supporting learning from variation.
Our scoping review found that informatics studies have focused on detecting of MPV, especially variability in treatments and deviation from practice guidelines. Technological advances should promote more informatics research focused on explaining and learning from MPV.
The Ovid integrated database was searched between 1946 and 2022 to identify MPV studies published in major informatics journals and conference proceedings. Two reviewers performed relevance screening, with assistance from another independent reviewer for adjudication. The included articles were then thematically analyzed and summarized through discussion among all three reviewers.
A total of 43 articles were included and went through the thematic analysis. About half (n = 21) of the included articles were published in conference proceedings. Five articles reported the effect of MPV on patient outcomes. The variation of interest was most frequently in treatment decisions. In terms of the role informatics played (multiple roles allowed), 39 (90.7%) articles pertained to detection of MPV, 5 were about prevention of MPV and 4 about learning from MPV.
MPV remains a critical issue in health care, yet most informatics research has been focused on simple tasks such as automating the detection of MPV and assessing compliance to decision-support systems, and less focused on addressing the causes of variation or supporting learning from variation.
Our scoping review found that informatics studies have focused on detecting of MPV, especially variability in treatments and deviation from practice guidelines. Technological advances should promote more informatics research focused on explaining and learning from MPV.
摘要：
背景：我们对有关医学实践变异（MPV）的信息学核心文献进行了范围审查，作为本领域主题的敏捷总结。
方法：在1946年至2022年之间搜索了Ovid集成数据库，以确定主要信息学期刊和会议记录上发表的MPV研究。两名审稿人进行了相关性筛选，在另一位独立评审员的协助下进行裁决。然后通过所有三位审稿人的讨论，对纳入的文章进行主题分析和总结。
结果：共纳入43篇文章，并进行了主题分析。所包括的文章中约有一半（n=21）在会议记录中发表。五篇文章报道了MPV对患者预后的影响。感兴趣的变化在治疗决定中最常见。就信息学所扮演的角色而言(允许多个角色)，39篇(90.7%)与MPV检测有关的文章，5个是关于MPV的预防，4个是关于MPV的学习。
结论：MPV仍然是医疗保健中的关键问题，然而，大多数信息学研究都集中在简单的任务上，如自动检测MPV和评估决策支持系统的合规性，而较少关注解决变异的原因或支持从变异中学习。
结论：我们的范围审查发现，信息学研究集中在检测MPV，尤其是治疗的可变性和与实践指南的偏差。技术进步应该促进更多的信息学研究，重点是解释和学习MPV。
方法：在1946年至2022年之间搜索了Ovid集成数据库，以确定主要信息学期刊和会议记录上发表的MPV研究。两名审稿人进行了相关性筛选，在另一位独立评审员的协助下进行裁决。然后通过所有三位审稿人的讨论，对纳入的文章进行主题分析和总结。
结果：共纳入43篇文章，并进行了主题分析。所包括的文章中约有一半（n=21）在会议记录中发表。五篇文章报道了MPV对患者预后的影响。感兴趣的变化在治疗决定中最常见。就信息学所扮演的角色而言(允许多个角色)，39篇(90.7%)与MPV检测有关的文章，5个是关于MPV的预防，4个是关于MPV的学习。
结论：MPV仍然是医疗保健中的关键问题，然而，大多数信息学研究都集中在简单的任务上，如自动检测MPV和评估决策支持系统的合规性，而较少关注解决变异的原因或支持从变异中学习。
结论：我们的范围审查发现，信息学研究集中在检测MPV，尤其是治疗的可变性和与实践指南的偏差。技术进步应该促进更多的信息学研究，重点是解释和学习MPV。
