We previously validated an expert computer program (Hemodyn) designed to assist in interpreting pulmonary artery catheterization data. The present multicentric study assessed the influence of Hemodyn on the therapeutic strategies of residents. Each resident made several diagnostic choices and suggested appropriate treatments based on pulmonary artery catheterization (PAC) data. After knowledge of the computer interpretation, the resident could either maintain or change his or her diagnosis and treatment under a senior supervision. Agreement between the residents' initial evaluation and the computer's was poor (kappa <0.6). After computer assistance, agreement improved dramatically (kappa >0.9). Computer assistance led the residents to change at least one suggested treatment in 63% of cases, and in 8% of cases the residents changed the initial suggestion to its opposite. Expert software capable of helping residents to interpret PAC data properly may improve the quality of care given to critically ill patients.
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| http://dx.doi.org/10.1007/s00134-003-1721-3 | DOI Listing |
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