Background Atrial fibrillation (AF) is one of the most common cardiac arrhythmia diseases. Thromboembolic prophylaxis plays an essential role in AF therapy, but at present, general practitioners (GPs) are presumed to lack the knowledge and enthusiasm for AF management. Clinical decision support systems (CDSS), assisted by artificial intelligence, help primary care providers (PCPs) make quick, individualized, and correct clinical decisions. This primary aim of the study is to identify whether the promotion of the CDSS would improve the primary care provided to patients with AF. The secondary objectives are mainly to assess the health-economic and clinical benefits from using the CDSS, and the improvement of GPs’ AF management capability. Methods This study will be a prospective cluster randomized controlled trial, conducted among 14 community health centers in Shanghai which were randomized as the intervention group and control group in a ratio of 1:1. The intervention group will use the CDSS in the consultation of patients with AF and the control group will maintain their usual care. The trial will include 498 patients with AF and the follow-up period will be 12 months. The primary outcome is set as the proportion of antithrombotic treatment prescriptions in agreement with recommendations in the latest China’s AF-related guidelines. The secondary outcomes are the frequency of consultation, the compliance rate of international normalized ratio (INR) in patients with warfarin, stroke morbidity, treatment compliance, medication satisfaction, and the cost-benefit analysis. Per-protocol (PP) analysis and the intention-to-treat (ITT) analysis will be conducted. Discussion This study aims to identify whether the application of CDSS to manage patients with AF in China’s community health centers would bring benefits for patients, physicians, and health economics. Trial registration Registry name: 非瓣膜性房颤社区AI辅助管理工具研发及推广效果研究 (Development and promotion of an AI-assisted tool for NVAF management in primary care); registry number: ChiCTR2100052307; registration date: Nov. 22nd, 2021; http://www.chictr.org.cn/showproj.aspx?proj=133849.
Objectives The aim of the study was to investigate the work competence of general practitioners (GPs) in the community health services (CHSs) of Shanghai, China. Methods A questionnaire was designed based on a previous capacity evaluation indicator system. We used a stratified and proportional cluster sampling method in this self-assessment and cross-sectional study. We collected data with the questionnaire on GPs’ demographic variables and work competence including patient care ability, teaching ability, communication skill and coordination ability. Univariate analyses were performed by Mann-Whitney U test and Kolmogorov-Smirnov test. Multivariate analyses were done with generalized liner model with significant univariate factors. Results A total of 2954 GPs were sampled from 116 CHSs in Shanghai. The response rate was 99.9%. The median scores of patient care ability, teaching ability, communication skill and coordination ability were 80[70–88.75], 76[60–80] and 80[70–85] on a scale of 100, respectively. GPs who were 30–39 years old, or worked in urban CHSs, or took GP trainer’s training or had teaching experience got higher scores in patient care ability. GPs who worked for 5–19 years in CHSs, or worked in CHSs with GP training program or took GP trainer’s training had higher scores in teaching ability. For communication skill and coordination ability, GPs who worked in CHSs with GP standardized training program, or took GP trainer’s training or had teaching experience in CHSs got higher scores. Conclusions The work competence of GPs in CHSs of Shanghai could mainly cover daily work, but still needed more improvement in teaching ability.
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