科学美国人60秒 SSS 改变电脑预设可减少阿片类药物处方量（在线收听）

This is Scientific American's 60-second Science, I'm Christopher Intagliata.

这里是科学美国人——60秒科学系列，我是克里斯托弗·因塔格里塔。

Used to be, when doctors prescribed a drug, they'd open up a book summarizing drugs and dosages—or go by memory for the common stuff. But nowadays?

以前，医生开药时会打开汇总药物和剂量的书，或凭借记忆开出常见药物。那现在呢？

"Now you can type in whatever it is. It's placing an order via the computer. So you type in an order of the name of the drug, and it'll prepopulate everything."

“现在你可以输入任何内容。用电脑开药单。

Juan Carlos Montoy is an emergency medicine physician at San Francisco General Hospital. He also studies decision-making in health care. He says for an antibiotic, the default dose programmed into a doctor's computer might be pretty standard. But for pain, the number of opioids prescribed might vary a lot, depending on the patient and their type of pain.

旧金山综合医院的急诊内科医师胡安·卡洛斯·蒙托伊说到。他还研究卫生保健方面的决策。他表示，对于抗生素，医生电脑中的默认剂量可能相当标准。但就疼痛而言，因患者及其疼痛种类不同，阿片类处方的剂量可能存在巨大差异。

"What we wanted to look at is: tell whether and to what extent the presets, the default settings we have in the electronic medical record, influenced provider prescribing."

“我们想研究的是：电子病历中的预设是否以及在多大程度上会影响处方提供者。”

Specifically, would lower defaults result in fewer opioids being prescribed?

具体来说，降低默认设置是否会减少阿片类药物处方？

So Montoy's team systematically changed the recommended-opioid-pill-number defaults in the computer systems of two hospitals in the San Francisco Bay Area during an eight-month period. Each hospital's preexisting defaults were 12 and 20 pills, respectively. The researchers dialed in new defaults of five, 10, 15 or an unspecified number of pills.

因此，蒙托伊的团队有组织地改变了旧金山湾区两家医院计算机系统中的阿片类药物默认推荐数量，时间持续八个月。每家医院先前的默认数量分别为12片和20片。研究人员调整的新默认值为5，10和15片或未说明数量。

Compared to doctors' prior prescribing habits, the new default settings resulted in fewer opioid pills prescribed overall—and fewer prescriptions exceeding the maximum recommendations by the Centers for Disease Control and Prevention.

研究人员调整的新默认值为5，10和15片或未说明数量。与医生之前的处方习惯相比，新默认值使阿片类药物处方整体数量下降，与医生之前的处方习惯相比，新默认值使阿片类药物处方整体数量下降，超过美国疾病控制和预防中心推荐数量最大值的处方量也减少了。

"This suggests that other hospitals, other emergency departments, clinics, can change those settings and impact opioid prescribing pretty much immediately. It's a really low-cost intervention and can be done really quickly."

“这表明，其他医院、急诊科和诊所都可以改变默认设置，立即影响阿片类药物处方。这的确是低成本且可以快速实施的干预措施。”

The results are in the Journal of the American Medical Association (JAMA) Internal Medicine.

研究结果发表在《美国医学会期刊——内科学》上。

"This is definitely not a silver bullet. The epidemic has a lot of different issues that need to be addressed, and this is one small tool we can use to address it."

“这绝对不是灵丹妙药。这一流行病有许多不同的问题需要解决，而这只是我们可以用来解决问题的一个小工具。”

Still, it could be a useful prescription for physicians.

不过，对医生来说，这可能是一个有用的“处方”。

Thanks for listening for Scientific American's 60-second Science. I'm Christopher Intagliata.

谢谢大家收听科学美国人——60秒科学。我是克里斯托弗·因塔利亚塔。