Clinical Decision Support Case Study

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2.3.3. Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success [16]. The Objective is to identify features of clinical decision support systems critical for improving clinical practice and was Design using Systematic review of randomized controlled trials. Data sources were gotten from Literature searches via Medline, CINAHL, and the Cochrane Controlled Trials Register up to 2003; and searches of reference lists of included studies and relevant reviews. Studies had to evaluate the ability of decision support systems to improve clinical practice. Studies were assessed for statistically and clinically significant improvement in clinical practice and for the presence of 15 decision support system features whose importance had been repeatedly suggested in the literature. Methods: Data sources, Inclusion and exclusion criteria, Study selection, Data…show more content…
Decision support systems significantly improved clinical practice in 68% of trials. Univariate analyses revealed that, for five of the system features, interventions possessing the feature were significantly more likely to improve clinical practice than interventions lacking the feature. Multiple logistic regression analysis identified four features as independent predictors of improved clinical practice: automatic provision of decision support as part of clinician workflow (P < 0.00001), provision of recommendations rather than just assessments (P = 0.0187), provision of decision support at the time and location of decision making (P = 0.0263), and computer based decision support (P = 0.0294). Of 32 systems possessing all four features, 30 (94%) significantly improved clinical practice. Furthermore, direct experimental justification was found for providing periodic performance feedback, sharing recommendations with patients, and requesting documentation of reasons for not following

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