Article
Computer Science, Information Systems
Henrik Thiess, Guilherme Del Fiol, Daniel C. Malone, Ryan Cornia, Max Sibilla, Bryn Rhodes, Richard D. Boyce, Kensaku Kawamoto, Thomas Reese
Summary: This study investigates the coordination of emerging HL7 standards with modular CDS architecture components and utilizes a modular, standards-based architecture consisting of four components. The implementation use-case is an application for supporting shared decision making in the context of drug interactions, implemented using FHIR, Clinical Quality Language, CDS Hooks, and Substitutable Medical Apps Reusable Technologies. The application was tested in a sandbox environment and an electronic health record test environment, and can be integrated into clinical workflows through on-demand access or CDS Hooks.
INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS
(2022)
Article
Computer Science, Information Systems
Alan H. Morris, Christopher Horvat, Brian Stagg, David W. Grainger, Michael Lanspa, James Orme, Terry P. Clemmer, Lindell K. Weaver, Frank O. Thomas, Colin K. Grissom, Ellie Hirshberg, Thomas D. East, Carrie Jane Wallace, Michael P. Young, Dean F. Sittig, Mary Suchyta, James E. Pearl, Antinio Pesenti, Michela Bombino, Eduardo Beck, Katherine A. Sward, Charlene Weir, Shobha Phansalkar, Gordon R. Bernard, B. Taylor Thompson, Roy Brower, Jonathon Truwit, Jay Steingrub, R. Duncan Hiten, Douglas F. Willson, Jerry J. Zimmerman, Vinay Nadkarni, Adrienne G. Randolph, Martha A. Q. Curley, Christopher J. L. Newth, Jacques Lacroix, Michael S. D. Agus, Kang Hoe Lee, Bennett P. DeBoisblanc, Frederick Alan Moore, R. Scott Evans, Dean K. Sorenson, Anthony Wong, Michael Boland, Willard H. Dere, Alan Crandall, Julio Facelli, Stanley M. Huff, Peter J. Haug, Ulrike Pielmeier, Stephen E. Rees, Dan S. Karbing, Steen Andreassen, Eddy Fan, Roberta M. Goldring, Kenneth Berger, Beno W. Oppenheimer, E. Wesley Ely, Brian W. Pickering, David A. Schoenfeld, Irena Tocino, Russell S. Gonnering, Peter J. Pronovost, Lucy A. Savitz, Didier Dreyfuss, Arthur S. Slutsky, James D. Crapo, Michael R. Pinsky, Brent James, Donald M. Berwick
Summary: Delivering the best care in various clinical settings is a challenging problem. Evidence-based guidelines currently address only a fraction of the care provided by clinicians, especially in underserved areas. The use of validated clinical decision support systems (eActions) could help overcome cognitive limitations in advanced healthcare environments.
JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION
(2022)
Review
Computer Science, Information Systems
Jukrin Moon, Jason S. Chladek, Paije Wilson, Michelle A. Chui
Summary: Despite various research conducted in community pharmacies, this scoping review confirms that research on CDSS in community pharmacies is limited and disjointed, lacking a comprehensive approach to highlight areas for improvement and ways to optimize CDSS utilization.
JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION
(2023)
Article
Computer Science, Information Systems
Xiaoni Zhang, Michelle Svec, Robert Tracy, Gary Ozanich
Summary: This study demonstrates the effectiveness of using clinical decision support tools and team-based care in improving treatment outcomes for poorly controlled diabetes patients. Through measured outcomes and online surveys, the study confirms the positive impact of clinical decision support tools and team-based care on provider decision-making and patient outcomes.
INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS
(2022)
Article
Computer Science, Information Systems
Katoo M. Muylle, Kristof Gentens, Alain G. Dupont, Pieter Cornu
Summary: The implementation of six optimization strategies in a clinical decision support system for drug-drug interaction screening resulted in high alert acceptance and clinical pharmacist intervention acceptance, with administration acceptance being significantly higher than prescription acceptance.
INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS
(2021)
Article
Computer Science, Information Systems
Florine A. Berger, Heleen van der Sijs, T. van Gelder, Aaf F. M. Kuijper, Patricia M. L. A. van den Bemt, Matthijs L. Becker
Summary: The study compared the performance of two algorithms for managing QT-DDIs and found that both algorithms showed good discriminative abilities to identify patients at risk for QTc prolongation, supporting the application of digital algorithms in clinical decision support systems for risk management of QT-DDIs.
INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS
(2021)
Review
Pharmacology & Pharmacy
Birgit A. Damoiseaux-Volman, Stephanie Medlock, Delanie M. van der Meulen, Jesse de Boer, Johannes A. Romijn, Nathalie van der Velde, Ameen Abu-Hanna
Summary: This scoping review aimed to summarize approaches and outcomes of clinical validation studies of CDSSs, with most studies focusing on detection of adverse drug events, potentially inappropriate medications, and drug-related problems. Heterogeneity was found in the methods used and outcome measures, emphasizing the need for a more systematic and comprehensive validation strategy in future research to improve the effectiveness and uptake of CDSSs.
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY
(2022)
Review
Medical Laboratory Technology
Andrew E. O. Hughes, Ronald Jackups
Summary: This article reviews common classes of CDS tools from literature examples and institutional experience, and provides practical framework and specific recommendations for effective CDS implementation. CDS encompasses a rich set of tools that have potential for significant improvements in laboratory testing, particularly in test utilization. Deploying CDS effectively requires thoughtful design, careful maintenance, and structured processes focused on quality improvement and change management.
CLINICAL CHEMISTRY
(2022)
Article
Cardiac & Cardiovascular Systems
Raymond L. Woosley
Summary: Adverse events due to prescription medications are often a cause of death and disability. Hospital-based Clinical Decision Support (CDS) systems have been developed to identify at-risk patients and help mitigate the risk of medication-induced harm, with the non-profit organization AZCERT playing a key role in assisting hospitals with these systems.
TRENDS IN CARDIOVASCULAR MEDICINE
(2022)
Editorial Material
Computer Science, Information Systems
Stuart Sommers, Heather Tolle, Cheryl Napier, Jason Hoppe
Summary: Clinical decision support (CDS) can prevent medical errors and improve patient outcomes. However, there is heterogeneity in the effectiveness of CDS and limited understanding of why some CDS are more successful than others. Clinicians often override CDS, and there is a lack of studies recommending how to address this issue. Targeted educational interventions can improve CDS adoption and effectiveness for nonadopters.
JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION
(2023)
Article
Pharmacology & Pharmacy
Felix Stader, Manuel Battegay, Catia Marzolini
Summary: Bictegravir is metabolized by CYP3A and UGT1A1, with PBPK modeling predicting the potential for safe coadministration with moderate dual perpetrators. Rifampicin's inducing effect on bictegravir can be reversed with concomitant strong inhibitors like ritonavir. PBPK modeling is an effective tool for guiding DDI management for novel drugs like bictegravir.
CLINICAL PHARMACOLOGY & THERAPEUTICS
(2021)
Article
Computer Science, Information Systems
E. Cuvelier, L. Robert, E. Musy, C. Rousseliere, R. Marcilly, S. Gautier, P. Odou, J. -B. Beuscart, B. Decaudin
Summary: Involving clinical pharmacists in the development and management of CDSS can reduce the number of irrelevant alerts and improve the acceptance rate of pharmaceutical interventions (PIs) by physicians. Standardized analysis of alerts by clinical pharmacists appears to be a good way of improving the development of CDSS by limiting the generation of irrelevant alerts.
INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS
(2021)
Article
Medicine, General & Internal
Stefan Russmann, Fabiana Martinelli, Franziska Jakobs, Manjinder Pannu, David F. F. Niedrig, Andrea Michelle Burden, Martina Kleber, Markus Bechir
Summary: Potential medication errors and related adverse drug events (ADE) are challenging in clinical medicine. Clinical decision support systems (CDSSs) can help identify preventable prescription errors but often lack specificity. In this study, CDSS performance was analyzed using two systems (pharmaVISTA and MediQ) to evaluate drug-drug interactions and other factors. Automated analyses produced an average of 15.5 alerts per patient, but expert evaluation resulted in only 0.8 recommendations per patient. Co-factors such as comorbidities and laboratory results were decisive for classifying CDSS alerts as clinically relevant.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Hematology
Tyler Gallo, Steven C. Curry, C. William Heise, Corneliu C. Antonescu, Robert A. Raschke
Summary: Clinical decision support based on the HIT-CR score can reduce unnecessary diagnostic testing for low-risk HIT patients.
BRITISH JOURNAL OF HAEMATOLOGY
(2023)
Article
Pharmacology & Pharmacy
Florine A. Berger, Heteen van der Sijs, Teun van Gelder, Patricia M. L. A. van den Bemt
Summary: A study on the impact of a clinical decision support (CDS) tool on the management of QTc-prolongation drug-drug interactions (QT-DDIs) showed a decrease in pharmacist interventions post-CDS tool, with the most common intervention being the substitution of interacting agents. The time spent on handling QT-DDIs was also reduced with the use of the CDS tool. Further improvements are needed to enhance the diagnostic value and reduce redundant alerts in the tool.
THERAPEUTIC ADVANCES IN DRUG SAFETY
(2021)
