Commentary
Variability in Therapeutic Decision Making: Evaluation of the Validity of an Information and Communication Technology Tool
Variabilidad en la toma de decisiones terapéuticas. A propósito de la evaluación de la fiabilidad de una herramienta TIC
F. Rivas Ruiz
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Unidad de Investigación, Agencia Sanitaria Costa del Sol, Marbella, Málaga, Spain
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Rivas Ruiz" "autores" => array:1 [ 0 => array:4 [ "nombre" => "F." "apellidos" => "Rivas Ruiz" "email" => array:2 [ 0 => "frivasruiz@gmail.com" 1 => "frivasr@hcs.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Unidad de Investigación, Agencia Sanitaria Costa del Sol, Marbella, Málaga, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Variabilidad en la toma de decisiones terapéuticas. A propósito de la evaluación de la fiabilidad de una herramienta TIC" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In a health care system burdened with large caseloads and shrinking resources, advances in information and communication technology have enormous potential to improve both efficiency and health outcomes. Especially valuable are tools for mobile telephones. Many technological initiatives, however, have been shown to have scarce ability to change clinical practice, whether because they proved impractical in actual use or because they were evaluated with inappropriate methods.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">This is not the case for the mobile telephone application MDi-Psoriasis introduced by Moreno-Ramírez et al.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">2</span></a> in this issue. This application is an innovative tool that can guide dermatologists making therapeutic decisions for patients with psoriasis. Its algorithms are based on current clinical practice guidelines. To test the tool's reliability, the authors used a robust approach to assessing agreement between the opinions of dermatologists expert in psoriasis and those issued by the application.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Another finding that emerged from the study was the high level of variability in the experts’ own therapeutic decisions, attributable to the numerous treatment options dermatologists have at their disposal today, particularly owing to interruptions in biologic therapy.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">3</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Rivas Ruiz F. Variabilidad en la toma de decisiones terapéuticas. A propósito de la evaluación de la fiabilidad de una herramienta TIC. Actas Dermosifiliogr. 2017;108:607.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0020" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Scaling up mHealth: Where is the evidence?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Tomlinson" 1 => "M.J. Rotheram-Borus" 2 => "L. Swartz" 3 => "A.C. Tsai" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.pmed.1001382" "Revista" => array:5 [ "tituloSerie" => "PLoS Med" "fecha" => "2013" "volumen" => "10" "paginaInicial" => "e1001382" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23424286" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0025" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "<span class="elsevierStyleInterRef" id="intr0010" href="http://dx.doi.org/10.1016/j.ad.2017.02.009">http://dx.doi.org/10.1016/j.ad.2017.02.009</span>" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fiabilidad de una aplicación de ayuda a la toma de decisiones terapéuticas en el paciente con psoriasis (MDi Psoriasis<span class="elsevierStyleSup">®</span>)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D. Moreno-Ramírez" 1 => "J.M. Herrerías-Esteban" 2 => "T. Ojeda-Vila" 3 => "J.M. Carrascosa" 4 => "G. Carretero" 5 => "P. de la Cueva" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2017" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0030" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Psoriasis for the primary care practitioner" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Young" 1 => "L. Aldredge" 2 => "P. Parker" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/2327-6924.12443" "Revista" => array:6 [ "tituloSerie" => "J Am Assoc Nurse Pract" "fecha" => "2017" "volumen" => "29" "paginaInicial" => "157" "paginaFinal" => "178" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28233460" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010800000007/v2_201708291348/S1578219017301865/v2_201708291348/en/main.assets" "Apartado" => array:4 [ "identificador" => "66476" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Commentaries" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010800000007/v2_201708291348/S1578219017301865/v2_201708291348/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219017301865?idApp=UINPBA000044" ]
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