Features of effective computerized clinical decision support systems: meta-regression of 162 randomized trials

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Background

Clinical Decision Support (CDSS) provide to physicians a tool that could help to make better and more informed decisions at the point of care. However, issues such as workflow disruption, lack of adequate training as well as cost of implementation prevent the wide adoption of CDSS.

Introduction

Evidence-based medicine provides to clinicians resources that can potentially decrease the amount of mistakes committed in the medical setting, enhancing the quality of healthcare services. In order to successfully implement a clinical decision support system there are important features and elements that a system should have in order to be efficient.

Design

Meta-regression analysis of randomized controlled trials

Methods

Analysis was based on a dataset of 162 randomized controlled trials in a recent series of systematic reviews of computerized clinical decision support systems.

Results

Results showed that systems presenting advice within electronic health records or order entry systems were less likely to improve outcomes when compared with standalone programs. Moreover, systems more likely to succeed are those that involve both clinician and patient probably because they make patients be more involved in their own care; however, the estimate of association was imprecise and requires further study.[1]

Conclusion

Researchers’ main objective was to identify elements that differentiate between effective and ineffective CDSS. Providing advice to both practitioners and patients as well as requiring practitioners to give explanations for over-riding advice, might independently improve success.

References

  1. Features of effective computerized clinical decision support systems: meta-regression of 162 randomized trials http://www.bmj.com.ezproxyhost.library.tmc.edu/content/346/bmj.f657.long