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Computerassistierte Entscheidungsfindung beim Traumapatienten

Computer-assisted decision-making for trauma patients

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Zusammenfassung

Hintergrund

Bei der Behandlung von Schockraumpatienten müssen in komplexen Situationen laufend und unter Zeitdruck zahlreiche kritische Entscheidungen getroffen werden. Auch erfahrene Teams machen hierbei häufig Fehler. Computerassistierte Entscheidungshilfen können basierend auf kontinuierlich eingespielten Informationen über den Zustand des Patienten anhand errechneter Wahrscheinlichkeiten weitere Behandlungsschritte vorschlagen. Die vorliegende Übersichtsarbeit fasst den aktuellen Stand der Literatur zur computerassistierten Entscheidungsfindung beim Traumapatienten zusammen.

Fragestellung

Literaturübersicht zu den vorhandenen Konzepten und Anwendungen der computerassistierten Entscheidungsfindung beim Traumapatienten.

Methodik

Narrativer Übersichtsartikel basierend auf einer Recherche der relevanten deutsch- und englischsprachigen Literatur der letzten 10 Jahre.

Ergebnisse

Es sind bereits einige gut funktionierende computerassistierte Entscheidungshilfen im Bereich der Traumaversorgung implementiert. Diverse Studien konnten zeigen, dass computerbasierte Entscheidungen im präklinischen Setting, im Schockraum und auf der traumatologischen Intensivstation das Behandlungsergebnis verbessern können. Zur weiteren Validierung und Implementierung müssen informationstechnische Barrieren behoben, die existierenden Systeme an die Datenschutzgesetze angeglichen und multizentrische Studien zur größeren Datenerhebung generiert werden.

Schlussfolgerung

Computerassistierte Entscheidungshilfen können helfen, die Versorgung von Traumapatienten zu verbessern. Für eine flächendeckende Anwendung müssen jedoch zuvor technische und legislative Barrieren überwunden werden.

Abstract

Background

In the management of trauma patients in the resuscitation room many time-pressured and critical decisions must continuously be made in complex situations. Even experienced teams frequently make errors in this context. Computer-assisted decision-making systems can predict critical situations based on patient data continuously acquired online. Based on the calculated predictions these systems can suggest the next steps in managing the patient. This review summarizes the current literature on computer-assisted decision-making in the management of trauma patients.

Objective

A literature review summarizing existing concepts and applications of computer-assisted decision-making support for the management of trauma patients.

Methods

Narrative review article based on an analysis of literature in the German and English languages from the last 10 years.

Results

There exist numerous computer-assisted decision-making systems in the field of trauma care. Several studies could show that computer-assisted decision-making can improve the outcome in the preclinical setting, the resuscitation room and in the intensive care unit. For further validation and implementation of these systems, information technological barriers have to be overcome, existing systems need to be adapted to current data protection regulations and large multicenter studies are necessary.

Conclusion

Computer-assisted decision-making can help to improve the management of trauma patients; however, before a ubiquitous implementation a number of technological and legislative barriers have to be overcome.

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Authors and Affiliations

  1. Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland

    Georg Osterhoff

  2. Klinik für Unfallchirurgie, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland

    Dominik Pförringer

  3. Klinik für Traumatologie, UniversitätsSpital Zürich, Rämistraße 100, CH-8091, Zürich, Schweiz

    Julian Scherer

  4. Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie/Stabsstelle Telemedizin, Universitätsklinikum Münster, Hüfferstraße 73–79, 48149, Münster, Deutschland

    Christian Juhra

  5. CMSC – Centrum für Muskuloskeletale Chirurgie, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland

    Sven Maerdian

  6. Klinik für Unfallchirurgie und Orthopädie, Septische und Rekonstruktive Chirurgie, Bundeswehrkrankenhaus Berlin, Scharnhorststr 13, 10115, Berlin, Deutschland

    David A. Back

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  1. Georg Osterhoff
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  2. Dominik Pförringer
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  4. Christian Juhra
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  5. Sven Maerdian
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Arbeitsgruppe Digitalisierung der Deutschen Gesellschaft für Orthopädie und Unfallchirurgie

Corresponding author

Correspondence to Georg Osterhoff.

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Interessenkonflikt

G. Osterhoff, D. Pförringer, J. Scherer, C. Juhra, S. Maerdian und D.A. Back geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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W. Mutschler, München

H. Polzer, München

B. Ockert, München

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Osterhoff, G., Pförringer, D., Scherer, J. et al. Computerassistierte Entscheidungsfindung beim Traumapatienten. Unfallchirurg 123, 199–205 (2020). https://doi.org/10.1007/s00113-019-0676-y

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