妊娠期糖尿病非药物管理决策支持系统的构建及应用

Construction and preliminary application of a non-drug management decision support system for gestational diabetes mellitus

目的构建妊娠期糖尿病(gestational diabetes mellitus,GDM)非药物管理决策支持系统,并进行初步应用,评价其在GDM管理中的可用性及准确性,为后期将该系统应用于临床奠定基础。方法成立系统构建小组,构建GDM非药物管理决策支持系统,该系统包括患者个人信息、血糖监测与预警、饮食监测与反馈、体重监测与反馈和运动记录5个模块。采用便利抽样法,选取2022年3月在上海市某妇产科医院产科营养门诊就诊的GDM患者作为研究对象,进行系统的初步应用。分析系统数据并调查GDM患者、系统构建小组成员、临床医护人员对于系统的可用性及结构化评价。结果GDM非药物管理决策支持系统识别血糖异常值并发送即刻处理提示的有效性为100%,生成血糖预警及预防报告的有效性为51%;GDM患者对于系统的可用性评价标准化得分为88.15分,系统构建小组人员和医护人员对于系统的结构化评价标准化得分为90.63分,均处于高水平。结论GDM非药物管理决策支持系统能够为医护人员及患者提供准确、客观的决策依据,初步应用结果显示,该系统的准确性较高、可用性良好,可进一步开展研究探讨其对改善患者血糖水平及妊娠结局的效果,以期改善现有GDM非药物管理模式。

Objective This study aims to develop a decision support system for the non-drug management of gestational diabetes mellitus(GDM),conduct a preliminary application study,evaluate its usability and accuracy in clinical practice,and lay the foundation for a randomized controlled trial to explore its application effects.Methods A research group on GDM was established to construct a decision support system for non-drug management of GDM.The man-machine interaction technology was employed to develop 5 modules,including patients’personal information,monitoring and feedback of blood glucose,diet,weight,and exercise records.The convenience sampling method was used to select GDM patients in the obstetrics nutrition clinic of a obstetrics and gynecology hospital in Shanghai in March 2022 as the research objects,and the systematic preliminary application was carried out.The data on using the system were analyzed,and surveys were conducted to evaluate the usability and structured evaluation of the system among medical staff,research groups,and patients.Results After initial application,the system was 100%effective in identifying abnormal blood glucose levels and sending immediate treatment tips,and 51%effective in generating blood glucose warning and prevention reports.The usability evaluation scores of GDM patients for the system and the structured evaluation scores of the system construction team members and health care workers were 88.15 and 90.63,respectively,which were both at a high level.Conclusion The system can provide accurate and objective decisions for medical staff and patients,and the preliminary application results reveal high accuracy and good usability.Additional studies can be conducted to investigate its effect on improving patients’blood glucose levels and pregnancy outcomes to enhance the existing non-drug management model for GDM.