An Environment for Guidelinebased Decision Support Systems for Outpatients Monitoring

Zini, Elisa Maria; Lanzola, Giordano; Bossi, Paolo; Quaglini, Silvana

doi:10.3414/me16-01-0142

Cited by 10 publications

(17 citation statements)

References 39 publications

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“…As illustrated, 66% (25/38) of the occurrences of themes identified 10 positive indicators of practitioner performance [ 16 - 18 , 21 , 23 - 25 , 28 - 31 , 33 - 35 , 37 , 38 , 40 , 44 , 45 , 47 - 50 ]. Practitioner performance was reported as more accurate prescribing, improved screening of patients, improved overall performance, increased awareness of patient conditions, improved follow-up due to better communication with patients, improved accuracy of diagnosis, improved documentation, improved benchmarking, improved care plans, and improved buy-in of CDSSs.…”

Section: Resultsmentioning

confidence: 99%

“…Practitioners using CDSSs experienced more accurate prescribing [ 16 , 24 , 28 , 35 , 38 ], improved screening [ 33 , 37 , 49 , 50 ], improved overall performance [ 21 , 29 , 34 , 44 ], improved care plans [ 17 , 25 , 30 , 47 ], improved documentation [ 31 , 40 ], overall improved buy-in for CDSSs [ 33 , 48 ], increased awareness of needs of patients [ 18 ], improved follow-up with patients due to enhanced communication channels enabled by the application [ 23 ], improved accuracy of diagnosis [ 34 ], and improved benchmarking [ 45 ].…”

Section: Resultsmentioning

confidence: 99%

“…Patients experienced improved symptoms [ 20 , 23 , 26 , 41 , 43 , 46 - 48 , 50 ], improved feedback from provider [ 17 , 31 , 42 , 45 ], improved disease management [ 21 , 35 , 37 ], improved efficacy of treatment [ 32 , 39 ], improved screening [ 15 , 27 ], and improved safety [ 34 ], and one study even reported improved mortality [ 44 ]. Although 11 articles did not discuss patient medical outcomes [ 16 , 18 , 19 , 24 , 25 , 28 - 30 , 33 , 40 , 49 ], only 3 reported no statistically significant difference in outcomes between control and intervention groups [ 22 , 36 , 38 ].…”

Section: Resultsmentioning

confidence: 99%

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Effects of Computerized Decision Support Systems on Practitioner Performance and Patient Outcomes: Systematic Review

Kruse¹,

Ehrbar²

2020

JMIR Med Inform

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Background Computerized decision support systems (CDSSs) are software programs that support the decision making of practitioners and other staff. Other reviews have analyzed the relationship between CDSSs, practitioner performance, and patient outcomes. These reviews reported positive practitioner performance in over half the articles analyzed, but very little information was found for patient outcomes. Objective The purpose of this review was to analyze the relationship between CDSSs, practitioner performance, and patient medical outcomes. PubMed, CINAHL, Embase, Web of Science, and Cochrane databases were queried. Methods Articles were chosen based on year published (last 10 years), high quality, peer-reviewed sources, and discussion of the relationship between the use of CDSS as an intervention and links to practitioner performance or patient outcomes. Reviewers used an Excel spreadsheet (Microsoft Corporation) to collect information on the relationship between CDSSs and practitioner performance or patient outcomes. Reviewers also collected observations of participants, intervention, comparison with control group, outcomes, and study design (PICOS) along with those showing implicit bias. Articles were analyzed by multiple reviewers following the Kruse protocol for systematic reviews. Data were organized into multiple tables for analysis and reporting. Results Themes were identified for both practitioner performance (n=38) and medical outcomes (n=36). A total of 66% (25/38) of articles had occurrences of positive practitioner performance, 13% (5/38) found no difference in practitioner performance, and 21% (8/38) did not report or discuss practitioner performance. Zero articles reported negative practitioner performance. A total of 61% (22/36) of articles had occurrences of positive patient medical outcomes, 8% (3/36) found no statistically significant difference in medical outcomes between intervention and control groups, and 31% (11/36) did not report or discuss medical outcomes. Zero articles found negative patient medical outcomes attributed to using CDSSs. Conclusions Results of this review are commensurate with previous reviews with similar objectives, but unlike these reviews we found a high level of reporting of positive effects on patient medical outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Effects of Computerized Decision Support Systems on Practitioner Performance and Patient Outcomes: Systematic Review

Kruse¹,

Ehrbar²

2020

JMIR Med Inform

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“…Of those that identified performance, 82% (14/17) identified positive effect on practitioner performance as a result of using CDSS. Ten articles (37%) did not discuss practitioner performance (16,17,(20)(21)(22)24,26,30,32,34).…”

Section: Table 2: Summary Of Themes Identified For Practitioner Perfomentioning

confidence: 99%

“…Two articles (7%) reported no statistical difference between control and intervention groups (27,29). Ten articles (37%) did not discuss patient medical outcomes (15)(16)(17)19,20,21,23,27,31,33,40).…”

Section: Table 3: Summary Of Themes Identified For Patient Medical Oumentioning

confidence: 99%

What are the Effects of Computerized Decision Support Systems on Practitioner Performance and Patient Outcomes

Kruse¹,

Ehrbar²

2019

Preprint

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Background Computerized decision support systems (CDSS) are software programs that support the decision making of practitioners and other staff. Other reviews have analyzed the relationship between CDSS, practitioner performance, and patient outcomes. These reviews reported positive practitioner performance in over half the articles analyzed, but very little information was found for patient outcomes. The purpose of this review was to analyze the relationship between CDSS, practitioner performance, and patient medical outcomes. PubMed, CINAHL, and Cochrane databases were queried.Methods 27 articles were chosen based on year published (last ten years), high quality source, and discussion of the relationship between the use of CDSS as an intervention and links to practitioner performance or patient outcomes. Reviewers used an Excel spreadsheet to collect information on the relationship between CDSS and practitioner performance or patient outcomes. Reviewers also collected observations of participants, intervention, comparison with control group, and outcomes (PICO) along with those showing implicit bias. Articles were analyzed by multiple reviewers following the Kruse Protocol for systematic reviews. Data were organized into multiple tables for analysis and reporting.Results Fourteen articles (52%) discussed positive practitioner performance, three articles (11%) found no difference in practitioner performance, ten articles (37%) did not discuss practitioner performance. Zero articles reported negative practitioner performance. Fifteen articles (56%) discussed positive patient medical outcomes, two articles (7%) found no statistically significant difference in medical outcomes between intervention and control groups, and ten articles (37%) did not discuss medical outcomes. Zero articles found negative patient medical outcomes.Conclusions Results of this review are commensurate with previous reviews with similar objectives, but unlike these reviews we found significant positive reporting of a positive effect on patient medical outcomes. Our findings support adoption of decision support systems.

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A pilot study of a smartphone-based monitoring intervention on head and neck cancer patients undergoing concurrent chemo-radiotherapy

Zini

Lanzola

Quaglini

et al. 2019

International Journal of Medical Informatics

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An Environment for Guidelinebased Decision Support Systems for Outpatients Monitoring

Cited by 10 publications

References 39 publications

Effects of Computerized Decision Support Systems on Practitioner Performance and Patient Outcomes: Systematic Review

Effects of Computerized Decision Support Systems on Practitioner Performance and Patient Outcomes: Systematic Review

What are the Effects of Computerized Decision Support Systems on Practitioner Performance and Patient Outcomes

A pilot study of a smartphone-based monitoring intervention on head and neck cancer patients undergoing concurrent chemo-radiotherapy

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