Effects of clinical decision-support systems on practitioner performance and patient outcomes: a synthesis of high-quality systematic review findings

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This is a review of Monique W M Jaspers, Marian Smeulers, Hester Vermeulen, Linda W Peute 2011 article, “Effects of clinical decision-support systems on practitioner performance and patient outcomes: a synthesis of high-quality systematic review findings”. [1]

Objective

The article summarized impact of clinical decision support systems on the performance of medical practitioner and the patient outcomes. Additionally, this article aimed to emphasize on areas where need more attention in term of research.

Methods

Authors defined a literature search strategy that consist of research on different clinical libraries (Such as Medline, Embase, and Inspec) and performed analysis on the best systematic reviews focused on CDS. In order to implement this strategy, researchers defined a two-stage procedure, publication selection with use of predefined criteria and an independent assessment approach by the measurement tool. They included systematic reviews with AMSTAR score 9 or above and rated them based on their level of evidence by two independent reviewers.

Results and Conclusion

The research result showed that 48.57% (17 out of 35) of pre-included reviews were had adequate quality to further investigated. 57.14% (52 out of 91) of cases showed an evidence that CDS has impact on practitioner performance. Finally, only 30% (25 out of 82) studies of the systematic reviews showed a unique evidence that the CDS have a positive impact on patient outcomes. Researchers concluded that among few studies focused on any benefits of CDS on patient outcomes, many had had very small sample size or had a narrow time frame to show any clinically important effects. The study shows a significant evidence of positive CDS impact on healthcare providers' performance which affects drug ordering and preventive care reminder systems. The explanation behind this finding comes from the fact that these CDS types need a very small amount of patient information that are available before the diagnosis notes prepared. In fact, they are generated at the time clinicians make the decisions.

Comments

This important research took a serious important step toward showing tangible effectiveness of clinical decision support systems in practitioner performance and patient outcomes. Different systematic reviews have been analyzed and a brief outcome of the research objectives have been produced. Additionally, one important aspect of this research is that it focused on areas that need more attention to understand the CDS impact more effectively. Although this article present some limitations, and also used materials developed more than a decade ago, when CDS systems were difficult to use and were in their early stages of development, it shows a guide and road-map for future research areas.

References

  1. Monique W M Jaspers, Marian Smeulers, Hester Vermeulen, Linda W Peute. 2011 Effects of clinical decision-support systems on practitioner performance and patient outcomes: a synthesis of high-quality systematic review findings. http://jamia.oxfordjournals.org/content/18/3/327