A Clinical Decision Support System (KNOWBED) to Integrate Scientific Knowledge at the Bedside: Development and Evaluation Study (Preprint)

Abstract

BACKGROUND The Evidence-Based Medicine (EBM) paradigm requires the development of skills of healthcare personnel in the efficient search of the literature and the application of formal rules for the evaluation of evidence contained in the medical literature. Incorporating this methodology into the decision-making process of routine clinical practice allows to improve the patients’ healthcare, leading to increase the patient safety and to optimize resource efficiency. OBJECTIVE To enable physicians to carry out decision-making processes based on EBM during their regular clinical practice in an agile method. METHODS Two basic components integrate the KNOWBED system: a knowledge station (web application) and a mobile application. KNOWBED system has been tested in in the context of the bronchiolitis pathology from the Paediatrics Unit from the “Virgen Macarena” University Hospital (Seville, Spain). The system was evaluated using two indicators: usability and effectiveness. RESULTS A technological system (KNOWBED system) has been designed, developed and validated to support clinical decision making in mobility based in standards that has been incorporated into the practice of physicians. From this tool, physicians can consult existing scientific knowledge at bedside and access of recommendations of clinical protocols established based on EBM. CONCLUSIONS KNOWBED system is considered a useful and innovative system by physicians. The surveys of usability filled in by the users of the system show that it is particularly easy to access the knowledge bases. However, this article sets out certain improvements to be made in future experiences.

A Clinical Decision Support System (KNOWBED) to Integrate Scientific Knowledge at the Bedside: Development and Evaluation Study

“…The scientific knowledge integration at the bedside with a mobile platform enables health care professionals to make faster and more effective decisions based on validated clinical practice experience. In this sense, a CDSS called the KNOWBED system [ 18 ] has been designed, which provides to the health care professional clinically relevant questions concerning the pathology of interest. These questions are associated with recommendations at the bedside, based on the scientific evidence in different existing knowledge bases (eg, massive reference bases, CPGs, systematic reviews).…”