Организация здравоохранения
EXPERT ASSESSMENTS IN CLINICAL PRACTICE: METHODOLOGY AND APPLICATION EXPERIENCE
V.G. Kudrina1,2, V.O. Bogdanova1,3,2, Yu.A. Dolgusheva2,4
1. Russian Medical Academy of Continuing Professional Education of Health of the Russian Federation, Moscow
2. Plekhanov Russian University of Economics"Moscow
3. National Medical Research Center of Endocrinology of the Ministry of Health of the Russian Federation, Moscow
4. National Medical Research Center of Cardiology named after Academician E.I. Chazov of the Ministry of Health of the Russian Federation, Moscow
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Summary:
Relevance. With the active introduction of digitalization in the healthcare system, the advent of artificial intelligence and technological development in general, the need for automation of an increasing number of medical work processes is increasing. At the same time, the opinion of experts reflects their intellectual work, the importance of which, with the introduction of technology, should in no way be devalued, but, on the contrary, should be taken into account as a matter of priority and influence decisions made both in the clinical and organizational and managerial spheres. Contradictions may arise that show the nature and complexity of experts coming to a consensus, forcing them to take into account the problems that stand in the way of alternative technology implementation. The clinic is the most sensitive area of medical activity, where the damage from underestimating the opinions of specialists is greatest. We present the experience of expert assessment using the example of an approach to polypharmotherapy in terms of solving problems of polypharmacy and drug interactions (MLV).
Objective: to adapt the methodology of expert assessments in the healthcare system to solving specific practical problems of clinical practice in the context of active digitalization using the example of one of the leading problems - polypragmasia and related drug interactions.
Materials and methods. The present medical statistical study included three consecutive stages and was organized according to the classical scheme of expert assessments. At the first stage, an expert assessment map was developed for specialists with experience in the field of clinical pharmacology, based on a previously published SWOT analysis of drug interactions [1]. At the second stage, a sociological study was conducted using an expert survey of clinical pharmacologists. Respondents were asked to fill out an expert assessment card in order to determine their opinion on the importance of SWOT analysis parameters and the frequency of their omission in clinical practice with scores from 1 to 10 points, where 1 is not important / not overlooked, 10 is extremely important/ often overlooked. The third stage included processing of the received material with statistical analysis of the received data.
Results and discussion. One of the problems of clinical practice is solving the problems of polypharmotherapy, among which drug interactions are highlighted, which are especially acute in conditions of polypragmasia, the prevalence of which among hospitalized patients can reach 64.9% [2], and in geriatric departments it can fluctuate and reach 90.5% [3,4]. The consequences of drug interactions include direct effects on the patient: the development of adverse side effects, a decrease in the expected therapeutic effect and, as a result, the development of complications of the underlying disease. A large amount of information about drug interactions can make it difficult to use it in clinical practice due to the lack of time for a doctor to fully analyze data on drug interactions and compare prescriptions. There is a great temptation to use technological solutions in all clinical work processes. However, it is extremely important for a doctor to prioritize clinical thinking and only apply automated medical decision support systems in the right areas of activity, mainly when analyzing patient data. To assess the importance of drug interaction parameters and the frequency of their omission in clinical practice, an expert assessment was conducted by specialists with experience in the field of clinical pharmacology. The assessment methodology had a classic approach to expert assessments - based on the results obtained, the consistency of expert opinions was analyzed for further formation of criteria for reducing the risks of polypharm therapy, the development and application of IBS. The mathematical component of calculations in the methodology has been strengthened to prove the reliability of the results. In general, the methodology used in the study has shown its suitability for use on a wide range of clinical issues.
Conclusion: Expert assessments are a reliable mechanism for dividing the spheres of medical activity according to the priority of automation of work processes. In organizational and managerial matters, a decision-making approach based on the consistency of expert opinions is used. For clinical tasks, it is preliminary to divide the problem into two components. The first of them is related to automated decision-making support in the treatment and diagnostic process in relation to patients, the second is related to providing scientific information to the analytical activities of specialists. A specific example of assessing the situation with polypragmasia proved the experts' focus on supporting a differentiated approach to digitalization in clinical practice.
Keywords expert assessment, work processes of medical activity, areas of digitalization effectiveness in clinical practice, polypharmacotherapy, drug interactions
Bibliographic reference:
V.G. Kudrina, V.O. Bogdanova, Yu.A. Dolgusheva, EXPERT ASSESSMENTS IN CLINICAL PRACTICE: METHODOLOGY AND APPLICATION EXPERIENCE // Scientific journal «Current problems of health care and medical statistics». - 2026. - №1;
URL: http://healthproblem.ru/magazines?textEn=1830 (date of access: 29.04.2026).
URL: http://healthproblem.ru/magazines?textEn=1830 (date of access: 29.04.2026).
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