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CDSS- (Clinical Decision Support System)

M Ghoddusi Johari, M H Dabaghmanesh, H Zare, A R Safaeian, Gh Abdollahifard
Background: Diabetes is a serious chronic disease, and its increasing prevalence is a global concern. If diabetes mellitus is left untreated, poor control of blood glucose may cause long-term complications. A big challenge encountered by clinicians is the clinical management of diabetes. Many IT-based interventions such ad CDSS have been made to improve the adherence to the standard care for chronic diseases. Objective: The aim of this study is to establish a decision support system of diabetes management based on diabetes care guidelines in order to reduce medical errors and increase adherence to guidelines...
September 2018: Journal of Biomedical Physics & Engineering
Savino Spadaro, Dan Stieper Karbing, Francesca Dalla Corte, Tommaso Mauri, Federico Moro, Antonio Gioia, Carlo Alberto Volta, Stephen Edward Rees
PURPOSE: To assess whether a clinical decision support system (CDSS) suggests PS and FIO2 maintaining appropriate breathing effort, and minimizing FIO2 . MATERIALS: Prospective, cross-over study in PS ventilated ICU patients. Over support (150% baseline) and under support (50% baseline) were applied by changing PS (15 patients) or PEEP (8 patients). CDSS advice was followed. Tension time index of inspiratory muscles (TTies), respiratory and metabolic variables were measured...
October 5, 2018: Journal of Critical Care
Nicole Hechte, Antje Wulff, Michael Marschollek
A wide range of Clinical Decision Support Systems (CDSS) have been developed. These CDSS are based on decision models, which normally have a knowledge- or data-driven approach. In this work a structured development of potential hybrid approaches was realized by the assessment of decision models and identification of their advantages and disadvantages. For the assessment of different decision models, eight criteria were identified and three of them were chosen as main criteria for CDSS: transparency, learning aptitude and handling of uncertain and vague knowledge...
2018: Studies in Health Technology and Informatics
Olakotan Olufisayo, Maryati Mohd Yusof, Sharifa Ezat Wan Puteh
Despite the widespread use of clinical decision support systems with its alert function, there has been an increase in medical errors, adverse events as well as issues regarding patient safety, quality and efficiency. The appropriateness of CDSS must be properly evaluated by ensuring that CDSS provides clinicians with useful information at the point of care. Inefficient clinical workflow affects clinical processes; hence, it is necessary to identify processes in the healthcare system that affect provider's workflow...
2018: Studies in Health Technology and Informatics
Eda Bilici, George Despotou, Theodoros N Arvanitis
Clinical practice guidelines (CPGs) document evidence-based information and recommendations on treatment and management of conditions. CPGs usually focus on management of a single condition; however, in many cases a patient will be at the centre of multiple health conditions (multimorbidity). Multiple CPGs need to be followed in parallel, each managing a separate condition, which often results in instructions that may interact with each other, such as conflicts in medication. Furthermore, the impetus to deliver customised care based on patient-specific information, results in the need to be able to offer guidelines in an integrated manner, identifying and managing their interactions...
January 2018: Digital Health
Clara Schaarup, Louise Bilenberg Pape-Haugaard, Ole Kristian Hejlesen
BACKGROUND: Chronic wounds such as diabetic foot ulcers, venous leg ulcers, and pressure ulcers are a massive burden to health care facilities. Many randomized controlled trials on different wound care elements have been conducted and published in the Cochrane Library, all of which have only a low evidential basis. Thus, health care professionals are forced to rely on their own experience when making decisions regarding wound care. To progress from experience-based practice to evidence-based wound care practice, clinical decision support systems (CDSS) that help health care providers with decision-making in a clinical workflow have been developed...
June 21, 2018: JMIR diabetes
Laura Légat, Sven Van Laere, Marc Nyssen, Stephane Steurbaut, Alain G Dupont, Pieter Cornu
BACKGROUND: Worldwide, the burden of allergies-in particular, drug allergies-is growing. In the process of prescribing, dispensing, or administering a drug, a medication error may occur and can have adverse consequences; for example, a drug may be given to a patient with a documented allergy to that particular drug. Computerized physician order entry (CPOE) systems with built-in clinical decision support systems (CDSS) have the potential to prevent such medication errors and adverse events...
September 7, 2018: Journal of Medical Internet Research
Ian A Scott, Peter I Pillans, Michael Barras, Christopher Morris
Prescribing of potentially inappropriate medications (PIMs) that pose more risk than benefit in older patients is a common occurrence across all healthcare settings. Reducing such prescribing has been challenging despite multiple interventions, including educational campaigns, audits and feedback, geriatrician assessment and formulary restrictions. With the increasing uptake of electronic medical records (EMRs) across hospitals, clinics and residential aged care facilities (RACFs), integrated with computerized physician order entry (CPOE) and e-prescribing, opportunities exist for incorporating clinical decision support systems (CDSS) into EMR at the point of care...
September 2018: Therapeutic Advances in Drug Safety
Mona Mostaghim, Tom Snelling, Brendan McMullan, Yean H Ewe, Beata Bajorek
AIM: To assess the impact of a computerised clinical decision support system (CDSS) on antibiotic use in hospitalised children with a presumptive diagnosis of uncomplicated community-acquired pneumonia (CAP). METHODS: Codes associated with lower respiratory tract infection were used to identify cases of presumed uncomplicated CAP requiring admission to a tertiary paediatric hospital. Random sampling of the periods between 1 October 2010 and 30 September 2012 (pre-CDSS) and 1 October 2012 and 30 September 2014 (post-CDSS) determined the sequence of case assessment by two independent investigators...
August 30, 2018: Journal of Paediatrics and Child Health
Mustafa Ozkaynak, Blaine Reeder, Cynthia Drake, Peter Ferrarone, Barbara Trautner, Heidi Wald
Background and Objectives: Clinical decision support systems (CDSS) hold promise to influence clinician behavior at the point of care in nursing homes (NHs) and improving care delivery. However, the success of these interventions depends on their fit with workflow. The purpose of this study was to characterize workflow in NHs and identify implications of workflow for the design and implementation of CDSS in NHs. Research Design and Methods: We conducted a descriptive study at 2 NHs in a metropolitan area of the Mountain West Region of the United States...
August 16, 2018: Gerontologist
G Scadding, J Bousquet, C Bachert, W J Fokkens, P W Hellings, E Prokopakis, O Pfaar, D Price
The 2nd Rhinology Future Debate, organized by EUFOREA (European Forum for Research and Education in Allergy and Airways diseases) was held in Brussels in December 2017. One of these debates addressed the position of MP-AzeFlu in allergic rhinitis (AR) treatment. The current article summarizes this debate; reviewing recent data, and exploring how this has been interpreted by experts and incorporated into AR management guidelines and a clinical decision support system (CDSS). The Allergic Rhinitis & its Impact on Asthma (ARIA) guideline position MP-AzeFlu firstline for the treatment of AR, and in preference to intranasal corticosteroids (INSs) during the first 2 weeks of treatment...
July 27, 2018: Rhinology
Siqi Liu, Adam Wright, Milos Hauskrecht
A clinical decision support system (CDSS) helps clinicians to manage patients, but malfunctions of its components or other systems on which it depends may affect its intended functions. Monitoring the system and detecting changes in its behavior that may indicate the malfunction can help to avoid any potential costs associated with its improper operation. In this paper, we investigate the problem of detecting changes in the CDSS operation, in particular its monitoring and alerting subsystem, by monitoring its rule firing counts...
July 2, 2018: Artificial Intelligence in Medicine
Simon R Knight, Khoa N Cao, Matthew South, Nicki Hayward, James P Hunter, John Fox
BACKGROUND: Live donor nephrectomy is an operation that places the donor at risk of complications without the possibility of medical benefit. Rigorous donor selection and assessment is therefore essential to ensure minimisation of risk and for this reason robust national guidelines exist. Previous studies have demonstrated poor adherence to donor guidelines. METHODS: We developed a clinical decision support system (CDSS), based upon national living donor guidelines, to facilitate the identification of contraindications, additional investigations, special considerations and the decision as to nephrectomy side in potential living donors...
July 18, 2018: Transplantation
Anne-Lise Courbis, Ruth Brigid Murray, Sylvie Arnavielhe, Davide Caimmi, Anna Bedbrook, Michiel Van Eerd, Govert De Vries, Gerard Dray, Ioana Agache, Mario Morais-Almeida, Claus Bachert, Karl Christian Bergmann, Sinthia Bosnic-Anticevich, Jan Brozek, Caterina Bucca, Paulo Camargos, Giorgio Walter Canonica, Warner Carr, Thomas Casale, Joao A Fonseca, Tari Haahtela, Omer Kalayci, Ludger Klimek, Piotr Kuna, Violeta Kvedariene, Desiree Larenas Linnemann, Phil Lieberman, Joaquim Mullol, Robyn Ohehir, Nikolaos Papadopoulos, David Price, Dermot Ryan, Boleslaw Samolinski, F Estelle Simons, Peter Tomazic, Massimo Triggiani, Arunas Valiulis, Erkka Valovirta, Martin Wagenmann, Magnus Wickman, Arzu Yorgancioglu, Jean Bousquet
BACKGROUND: Allergic rhinitis (AR) management has changed in recent years following the switch from the concept of disease severity to the concept of disease control, publication of the AR clinical decision support system (CDSS) and development of mobile health (m-health) tools for patients (eg Allergy Diary). The Allergy Diary Companion app for healthcare providers is currently being developed and will be launched in 2018. It incorporates the AR CDSS to provide evidence-based treatment recommendations, linking all key stakeholders in AR management...
July 12, 2018: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
Rebekah Eden, Andrew Burton-Jones, Ian Scott, Andrew Staib, Clair Sullivan
Objective The transition to digital hospitals is fast-moving. Although US hospitals are further ahead than some others in implementing eHealth technologies, their early experiences are not necessarily generalisable to contemporary healthcare because both the systems and technologies have been rapidly evolving. It is important to provide up-to-date assessments of the evidence available. The aim of this paper is to provide an assessment of the current literature on the effects to be expected from hospital implementations of eHealth technologies...
July 10, 2018: Australian Health Review: a Publication of the Australian Hospital Association
Warren M Perry, Rubayet Hossain, Richard A Taylor
BACKGROUND: The use of big data and machine learning within clinical decision support systems (CDSSs) has the potential to transform medicine through better prognosis, diagnosis and automation of tasks. Real-time application of machine learning algorithms, however, is dependent on data being present and entered prior to, or at the point of, CDSS deployment. Our aim was to determine the feasibility of automating CDSSs within electronic health records (EHRs) by investigating the timing, data categorization, and completeness of documentation of their individual components of two common Clinical Decision Rules (CDRs) in the Emergency Department...
July 3, 2018: BMC Emergency Medicine
Rezvan Rahimi, Alireza Kazemi, Hamid Moghaddasi, Khadijeh Arjmandi Rafsanjani, Gholamreza Bahoush
OBJECTIVE: Chemotherapy medication errors are catastrophic. The prescription phase in the chemotherapy process plays a key role in the creation of medication errors, and therefore the use of computerized physician order entry (CPOE) and clinical decision support system (CDS) systems is recommended to reduce chemotherapy medication errors. The purpose of this study was to carry out a systematic review on the specifications of the CPOE and CDS systems for chemotherapy prescription. MATERIALS AND METHODS: A systematic review on articles published in English up to September 22, 2017, using the 3 databases PubMed, Embase, and Medline was conducted...
2018: Chemotherapy
Gaud Catho, Marlieke De Kraker, Brigitte Waldispühl Suter, Roberta Valotti, Stephan Harbarth, Laurent Kaiser, Luigia Elzi, Rodolphe Meyer, Enos Bernasconi, Benedikt D Huttner
INTRODUCTION: Inappropriate use of antimicrobials in hospitals contributes to antimicrobial resistance. Antimicrobial stewardship (AMS) interventions aim to improve antimicrobial prescribing, but they are often resource and personnel intensive. Computerised decision supportsystems (CDSSs) seem a promising tool to improve antimicrobial prescribing but have been insufficiently studied in clinical trials. METHODS AND ANALYSIS: The COMPuterized Antibiotic Stewardship Study trial, is a publicly funded, open-label, cluster randomised, controlled superiority trial which aims to determine whether a multimodal CDSS intervention integrated in the electronic health record (EHR) reduces overall antibiotic exposure in adult patients hospitalised in wards of two secondary and one tertiary care centre in Switzerland compared with 'standard-of-care' AMS...
June 27, 2018: BMJ Open
Pengli Jia, Pujing Zhao, Jingjing Chen, Mingming Zhang
BACKGROUND: Systematic reviews (SRs) have shown that clinical decision support systems (CDSSs) have the potential to improve diabetes care. However, methods of measuring and presenting outcomes are varied, and conclusions have been inconsistent. In addition, the reporting and methodological quality in this field is unknown, which could affect the integrity and accuracy of research. Therefore, it is difficult to confirm whether CDSSs are effective in improving diabetes care. OBJECTIVE: To comprehensively evaluate the effects of CDSS on diabetes care and to examine the methodological and reporting qualities...
June 26, 2018: Journal of Evaluation in Clinical Practice
Antti Tolonen, Hanneke F M Rhodius-Meester, Marie Bruun, Juha Koikkalainen, Frederik Barkhof, Afina W Lemstra, Teddy Koene, Philip Scheltens, Charlotte E Teunissen, Tong Tong, Ricardo Guerrero, Andreas Schuh, Christian Ledig, Marta Baroni, Daniel Rueckert, Hilkka Soininen, Anne M Remes, Gunhild Waldemar, Steen G Hasselbalch, Patrizia Mecocci, Wiesje M van der Flier, Jyrki Lötjönen
Clinical decision support systems (CDSSs) hold potential for the differential diagnosis of neurodegenerative diseases. We developed a novel CDSS, the PredictND tool, designed for differential diagnosis of different types of dementia. It combines information obtained from multiple diagnostic tests such as neuropsychological tests, MRI and cerebrospinal fluid samples. Here we evaluated how the classifier used in it performs in differentiating between controls with subjective cognitive decline, dementia due to Alzheimer's disease, vascular dementia, frontotemporal lobar degeneration and dementia with Lewy bodies...
2018: Frontiers in Aging Neuroscience
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