Abstract
In critical care, computer applications have made multiple contributions, from coordinating data to assisting in medical decision making. Interactive decision support systems are structured to incorporate patient data and standard clinical protocols for management in given patient situations. Computerized protocols always respond to a given clinical situation in the same manner, thus providing a tool for controlling post-randomization random and systematic variations in non-blinded clinical outcome studies. An intensive care unit must have a robust critical care information system to implement computerized protocols. This system must have the facility to collect real-time, valid data automatically and accurately. Development and implementation of protocols must be the role of a dedicated group of clinicians and Information Technology staff. Logic must be approved by consensus based on expert knowledge and published literature. Personality styles and biases should not be allowed to contaminate the protocol decision making process. Computerizing protocols is inherently educational. Precisely encoding otherwise vague clinical practices makes what is (and what is not) known, explicit.
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