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CDSS- (Clinical Decision Support System)

Azita Yazdani, Reza Safdari, Marjan Ghazisaeedi, Hamid Beigy, Roxana Sharifian
Introduction: In recent years, a variety of clinical decision-support systems (CDSS) have been developed to monitor the health of patients with chronic disease from far away. These systems are effective in overcoming human resource limitation and analyzing information generated by Tele-monitoring systems. These systems, however, are limited to monitoring a particular disease, which allows them to be used only in one specific disease. In reuses of these systems to monitor other diseases, we need to re-establish a new system with a new knowledge base...
October 2018: Acta Informatica Medica: AIM
Johanna Schwarz, Dominik Heider
Motivation: Clinical decision-support-systems (CDSS) have been applied in numerous fields, ranging from cancer survival towards drug resistance prediction. Nevertheless, CDSS typically have a caveat: many of them are perceived as black-boxes by non-experts and, unfortunately, the obtained scores cannot usually be interpreted as class probability estimates. In probability-focused medical applications, it is not sufficient to perform well with regards to discrimination and, consequently, various calibration methods have been developed to enable probabilistic interpretation...
November 29, 2018: Bioinformatics
Dimitrios Zikos, Nailya DeLellis
Clinical Decision Support Systems (CDSS) provide aid in clinical decision making and therefore need to take into consideration human, data interactions, and cognitive functions of clinical decision makers. The objective of this paper is to introduce a high level reference model that is intended to be used as a foundation to design successful and contextually relevant CDSS systems. The paper begins by introducing the information flow, use, and sharing characteristics in a hospital setting, and then it outlines the referential context for the model, which are clinical decisions in a hospital setting...
November 16, 2018: BMC Medical Research Methodology
S Paredes, J Henriques, T Rochar, D Mendes, P Carvalho, J Moraisl, A Bianchi, V Salcedof
The effectiveness of predictive models in supporting the Clinical Decision is closely related with their clinical interpretability, i.e.the model should provide clear information on how to reach a specific classification/decision. In fact, the development of interpretable and accurate predictive models assumes a key importance as these tools can be very useful in Clinical Decision Support Systems (CDSS). The development of those models may comprise two main perspectives; existent clinical knowledge (clinical expert knowledge, clinical guidelines, current models, etc...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Yung-Fu Chen, Chih-Sheng Lin, Chun-Fu Hong, D J Lee, Changming Sun, Hsuan-Hung Lin
Erectile dysfunction (ED) affects millions of men worldwide. Men with ED generally complain failure to attain or maintain an adequate erection during sexual activity. The prevalence of ED is strongly correlated with age, affecting about 40% of men at age 40 and nearly 70% at age 70. A variety of chronic diseases, including diabetes, ischemic heart disease, congestive heart failure, hypertension, depression, chronic renal failure, obstructive sleep apnea, prostate disease, gout, and sleep disorder, were reported to be associated with ED...
October 23, 2018: IEEE Journal of Biomedical and Health Informatics
Esther Melinda Mahabee-Gittens, Ashley L Merianos, Judith W Dexheimer, Gabe T Meyers, Lara Stone, Meredith Tabangin, Jane C Khoury, Judith S Gordon
BACKGROUND: Clinical decision support systems (CDSS) may facilitate caregiver tobacco screening and counseling by pediatric urgent care (UC) nurses. OBJECTIVE: This study aimed to assess the feasibility of a CDSS to address caregivers' tobacco use and child tobacco smoke exposure (TSE). METHODS: We conducted a 3-month prospective study on caregivers screened using a CDSS. Nurses used the CDSS to advise, assess, and assist caregivers to quit...
October 19, 2018: Pediatric Emergency Care
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...
December 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 L├ęgat, 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
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