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CDSS- (Clinical Decision Support System)

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
A-L Courbis, R Murray, S Arnavielhe, D Caimmi, A Bedbrook, M Van Eerd, G De Vries, G Dray, I Agache, M Morais-Almeida, C Bachert, K C Bergmann, S Bosnic-Anticevich, J Brozek, C Bucca, P Camargos, G W Canonica, W Carr, T Casale, Jaoa A Fonseca, T Haahtela, O Kalayci, L Klimek, P Kuna, V Kvedariene, D Larenas Linnemann, P Lieberman, J Mullol, R Ohehir, N G Papadopoulos, D Price, D Ryan, B Samolinski, F E Simons, P Tomazic, M Triggiani, A Valiulis, E Valovirta, M Wagenmann, M Wickman, A Yorgancioglu, J 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 (e.g. Allergy Diary). The Allergy Diary Companion app for health care 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...
July 3, 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
Stephen W Reddel, Michael H Barnett, Sean Riminton, Tej Dugal, Katherine Buzzard, Chenu Tim Wang, Fiona Fitzgerald, Heidi N Beadnall, Diane Erickson, David Gahan, Daniel Wang, Toby Ackland, Richard Thompson
BACKGROUND: Alemtuzumab is a highly effective treatment for relapsing-remitting multiple sclerosis (MS) but requires ongoing pathology monitoring for autoimmune adverse effects. The Alemtuzumab in MS Safety Systems (AMS3) study evaluated the implementation of an automated pathology-monitoring system. OBJECTIVES: To develop an efficient automated clinical decision support system (CDSS) to electronically prompt and track pathology collection and to provide prescribers and patients with customised alerts of abnormal results for identified risks...
June 1, 2018: Multiple Sclerosis: Clinical and Laboratory Research
Barbara Giannini, Mauro Giacomini
The importance of decision support systems is highly acknowledged as a key strategy to improve medical safety and quality of care. A strong interoperability between the hospital Electronic Health Record (EHR) and the Clinical Decision Support System (CDSS) is the key to reach a most reliable decision support, that could aid in better diagnosis, reduce medication errors and improve practitioner performances. Interoperability is granted by the use of standards for data representation and for system intercommunication...
2018: Studies in Health Technology and Informatics
Jafna L Cox, Ratika Parkash, Syed Sr Abidi, Lehana Thabane, Feng Xie, James MacKillop, Samina R Abidi, Antonio Ciaccia, Shurjeel H Choudhri, A Abusharekh, Joanna Nemis-White
The Integrated Management Program Advancing Community Treatment of Atrial Fibrillation (IMPACT-AF) is an investigator designed, prospective, randomized, un-blinded, cluster design clinical trial, conducted in the primary care setting of Nova Scotia, Canada. Its aim is to evaluate whether an electronic Clinical Decision Support System (CDSS) designed to assist both practitioners and patients with evidence-based management strategies for Atrial Fibrillation (AF) can improve process of care and outcomes in a cost-efficient manner as compared to usual AF care...
July 2018: American Heart Journal
Fei Wang, Beth Prier, Karri A Bauer, John Mellett
PURPOSE: The development and implementation of a clinical decision support system (CDSS) for pharmacists to use for identification of and intervention on patients with Staphylococcus aureus bacteremia (SAB) are described. SUMMARY: A project team consisting of 3 informatics pharmacists and 2 infectious diseases (ID) pharmacists was formed to develop the CDSS. The primary CDSS component was a scoring system that generates a score in real time for a patient with a positive blood culture for S...
June 1, 2018: American Journal of Health-system Pharmacy: AJHP
Gurpreet Singh, Lakshminarayanan Samavedham, Erle Chuen-Hian Lim
BACKGROUND: Understanding disease progression of neurodegenerative diseases (NDs) is important for better prognosis and decisions on the appropriate course of treatment to slow down the disease progression. NEW METHOD: We present here an innovative machine learning framework capable of (1) indicating the trajectory of disease progression by identifying relevant imaging biomarkers and (2) automated disease diagnosis. Self-Organizing Maps (SOM) have been used for data dimensionality reduction and to reveal potentially useful disease-specific biomarkers, regions of interest (ROIs)...
July 15, 2018: Journal of Neuroscience Methods
Sophie Desmedt, Anne Spinewine, Michel Jadoul, Séverine Henrard, Dominique Wouters, Olivia Dalleur
Background A clinical decision support system (CDSS) linked to the computerized physician order entry may help improve prescription appropriateness in inpatients with renal insufficiency. Objective To evaluate the impact on prescription appropriateness of a CDSS prescriber alert for 85 drugs in renal failure patients. Setting Before-after study in a 975-bed academic hospital. Method Prescriptions of patients with renal failure were reviewed during two comparable periods of 6 days each, before and after the implementation of the CDSS (September 2009 and 2010)...
May 21, 2018: International Journal of Clinical Pharmacy
Peyman Rezaei-Hachesu, Taha Samad-Soltani, Sajad Yaghoubi, Marjan GhaziSaeedi, Kayvan Mirnia, Hossein Masoumi-Asl, Reza Safdari
INTRODUCTION: Neonatal intensive care units (NICUs) have complex patients in terms of their diagnoses and required treatments. Antimicrobial treatment is a common therapy for patients in NICUs. To solve problems pertaining to empirical therapy, antimicrobial stewardship programs have recently been introduced. Despite the success of these programs in terms of data collection, there is still inefficiency in terms of analyzing and reporting the data. Thus, to successfully implement these stewardship programs, the design of antimicrobial resistance (AMR) surveillance systems is recommended as a first step...
July 2018: International Journal of Medical Informatics
Antje Wulff, Birger Haarbrandt, Erik Tute, Michael Marschollek, Philipp Beerbaum, Thomas Jack
BACKGROUND: Clinical decision-support systems (CDSS) are designed to solve knowledge-intensive tasks for supporting decision-making processes. Although many approaches for designing CDSS have been proposed, due to high implementation costs, as well as the lack of interoperability features, current solutions are not well-established across different institutions. Recently, the use of standardized formalisms for knowledge representation as terminologies as well as the integration of semantically enriched clinical information models, as openEHR Archetypes, and their reuse within CDSS are theoretically considered as key factors for reusable CDSS...
May 9, 2018: Artificial Intelligence in Medicine
Meredith Hand, Matthew A Kemertzis, Michelle Peate, Lynn Gillam, Maria McCarthy, Lisa Orme, Yves Heloury, Michael Sullivan, Margaret Zacharin, Yasmin Jayasinghe
PURPOSE: Fertility preservation discussions with pediatric and adolescent cancer patients can be difficult for clinicians. This study describes the acceptability of a fertility clinician decision support system (CDSS). METHODS: A cross-sectional study of clinicians at The Royal Children's Hospital, Melbourne. Participants were trained on CDSS purpose, contents, and use. A survey captured the perceived benefits and weaknesses of the CDSS. RESULTS: Thirty-nine clinicians participated...
May 7, 2018: Journal of Adolescent and Young Adult Oncology
Markus Meyer, Klaus Donsa, Thomas Truskaller, Matthias Frohner, Birgit Pohn, Alexander Felfernig, Frank Sinner, Thomas Pieber
BACKGROUND: A fast and accurate data transmission from glucose meter to clinical decision support systems (CDSSs) is crucial for the management of type 2 diabetes mellitus since almost all therapeutic interventions are derived from glucose measurements. OBJECTIVES: Aim was to develop a prototype of an automated glucose measurement transmission protocol based on the Continua Design Guidelines and to embed the protocol into a CDSS used by healthcare professionals...
2018: Studies in Health Technology and Informatics
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