In this Editorial, I highlight 2 critical issues for advancing the impact of the science and application of biomedical and health informatics methods, processes, and tools: replication studies and diversity, equity, and inclusion. In a previous article in Journal of the American Medical Informatics Association, Coiera et al¹ asked if health informatics had a replication crisis and concluded that “taking replication seriously is essential if biomedical and health informatics is to be an evidence-based discipline.” In this issue, Coiera and Tong² assess the frequency, fidelity, and impact of replication studies in the clinical decision support system (CDSS) literature. They identified CDSS replications across 28 health and biomedical informatics journals, assessed fidelity to the original study using 5 categories (identical, substitutable, in-class, augmented, out-of-class) and an innovative framework comprising 7 domains (investigators, method, population, intervention, setting, comparator, and outcome [IMPISCO]). Only 12 of 4063 publications retrieved from their search strategy were identified as actual replications; 6 related to one computer-based order entry study and replicated but which did not reproduce the findings of the original study. The authors conclude that “attention to replication should improve the efficiency and effectiveness of CDSS research” and call for characterization of core CDSS principles that require replication, identification of past replication data, and conduct of missing replication studies. The methods developed for this study, including the IMPISCO framework, fidelity scores, and fidelity heat map, as well as a proposed reporting structure for clearly identifying replication studies, provide a foundation not only for examining replication in CDSSs, but also for other informatics innovations.

中文翻译：

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复制研究和多样性、公平性和包容性策略对于推进生物医学和健康信息学的影响至关重要

在这篇社论中，我强调了推动生物医学和健康信息学方法、过程和工具的科学和应用的影响的两个关键问题：复制研究和多样性、公平性和包容性。在《 美国 医学 信息学 协会杂志》之前的一篇文章中，Coiera 等人¹询问健康信息学是否存在复制危机，并得出结论：“如果生物医学和健康信息学要成为一门循证学科，那么认真对待复制是必不可少的。” 在本期中，Coiera 和 Tong ²评估临床决策支持系统 (CDSS) 文献中重复研究的频率、保真度和影响。他们确定了 28 种健康和生物医学信息学期刊的 CDSS 重复，使用 5 个类别（相同、可替代、课堂内、增强、课堂外）和一个包含 7 个领域（调查员、方法、人群、干预、环境、比较和结果 [IMPISCO]）。从他们的搜索策略中检索到的 4063 篇出版物中，只有 12 篇被确定为实际复制品；6 与一项基于计算机的订单输入研究相关并进行了复制，但并未复制原始研究的结果。作者得出结论“对复制的关注应该提高 CDSS 研究的效率和有效性”，并呼吁对需要复制的核心 CDSS 原则进行表征，识别过去的复制数据，并进行缺失的复制研究。为本研究开发的方法，包括 IMPISCO 框架、保真度分数和保真度热图，以及用于明确识别复制研究的拟议报告结构，不仅为检查 CDSS 中的复制提供了基础，也为其他信息学创新提供了基础.