Evaluation of an expert system in resident physicians for the nutritional management of critically ill patients with intestinal insufficiency and failure

Information technology has provided medicine and nutrition with decision support tools, which have allowed a more objective and timely care to patients. An expert system is one of these tools with the potential to guide users in handling a specific problem. Adherence to clinical practice guidelines for nutritional management in patients with intestinal insufficiency and failure, through an expert system, optimizes the treatment of critically ill patients and increases their chances of survival. Objective: To establish an expert system developed as a tool to improve the adherence of physicians to international guidelines and as support in decision-making, improves the management of nutritional support in patients with intestinal insufficiency and failure. Methods: A questionnaire prepared by five experts through a modified three-round Delphi process was used to generate consensus on the questions that resident physicians had to answer when evaluating knowledge of international guidelines for nutritional management in these patients. Consensus was established through descriptive statistics, when agreement reached 80% or more in each of the questions. The questionnaire was applied to 26 resident physicians who rotated through the intensive care unit at a local hospital, half with support from the System and the other half without it. Results: The use of the System was shown to be a support for the resident physicians who used it (P value = 0.044). Providing assistance for better results, fewer errors in the written test and better adherence to the recommendations of international guidelines. Conclusions: the results found suggest that the use of the System can improve decision-making regarding the medical and nutritional approach in patients with intestinal insufficiency and failure.