Advances in Clinical Decision Support Systems: Contributions from the 2022 Literature

Christoph U. Lehmann; Vignesh Subbian; Section Editors for the IMIA Yearbook Section on Decision Support Systems

doi:10.1055/s-0043-1768751

Yearbook of Medical Informatics, Table of Contents

CC BY-NC-ND 4.0 · Yearb Med Inform 2023; 32(01): 179-183
DOI: 10.1055/s-0043-1768751

Section 6: Decision Support

Synopsis

Advances in Clinical Decision Support Systems: Contributions from the 2022 Literature

Authors

Christoph U. Lehmann

¹Clinical Informatics Center, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
Vignesh Subbian

²College of Engineering, The University of Arizona, Tucson, Arizona, USA

Section Editors for the IMIA Yearbook Section on Decision Support Systems

Abstract

Summary

Objective: To summarize significant research contributions published in 2022 in the field of clinical decision support (CDS) systems and select the best papers for the Decision Support section of the International Medical Informatics Association (IMIA) Yearbook 2023.

Methods: A renewed search query for identifying CDS scholarship was developed using Medical Subject Headings (MeSH) terms and related keywords. The query was executed in PubMed in January 2023. The search results were reviewed in three stages by two reviewers: title-based triaging, followed by abstract screening, and then full text review. The resulting articles were sent for external review to identity best paper candidates.

Results: A total of 1,939 articles related to CDS were retrieved. Of these, 11 articles were selected as candidates for best papers. The general themes of the final three best papers are (1) reducing documentation burden through in-line guidance for clinical notes, (2) clinician engagement for continuous improvement of CDS, and (3) mitigating healthcare-related carbon emissions using scalable and accessible CDS, respectively.

Conclusion: The field of clinical decision support remains highly active and dynamic, with innovative contributions to a range of clinical domains from primary to acute care. Interoperability issues, documentation burden, clinician acceptance, and the need for effective integration into existing healthcare workflows are among the prominent challenges and areas of interest faced by CDS implementation efforts.

Keywords

Medical informatics - clinical decision support system - implementation, expert system

Full Text

References

References
1 Douthit BJ, McCo, A., Nelson SD. The Impact of Clinical Decision Support on Health Disparities and the Digital Divide. Yearb Med Inform 2023:169-78. doi: 10.1055/s-0043-1768722.
2 Lamy J-B, Séroussi B, Griffon N, Kerdelhué G, Jaulent M-C, Bouaud J. Toward a formalization of the process to select IMIA Yearbook best papers. Methods Inf Med 2015; 54:135-44. doi:10.3414/ME14-01-0031.
3 Borbolla D, Colicchio TK. Clinical Decision Support Systems: Contributions from 2021. Yearb Med Inform 2022;31:199–201. doi:10.1055/s-0042-1742528.
4 Ostropolets A, Zhang L, Hripcsak G. A scoping review of clinical decision support tools that generate new knowledge to support decision making in real time. J Am Med Inform Assoc 2020;27:1968–76. doi:10.1093/jamia/ocaa200.
5 Donabedian A. The quality of care. How can it be assessed? JAMA 1988 260:1743–8. doi:10.1001/jama.260.12.1743.
6 Atia J, Evison F, Gallier S, Pettler S, Garrick M, Ball S, et al. Effectiveness of clinical decision support in controlling inappropriate red blood cell and platelet transfusions, speciality specific responses and behavioural change. BMC Med Inform Decis Mak 2022;22:342. doi:10.1186/s12911-022-02045-8.
7 Wu RR, Myers RA, Neuner J, McCarty C, Haller IV, Harry M, et al. Implementation-effectiveness trial of systematic family health history based risk assessment and impact on clinical disease prevention and surveillance activities. BMC Health Serv Res 2022;22:1486. doi:10.1186/s12913-022-08879-2.
8 Ramaswamy P, Shah A, Kothari R, Schloemerkemper N, Methangkool E, Aleck A, et al. An Accessible Clinical Decision Support System to Curtail Anesthetic Greenhouse Gases in a Large Health Network: Implementation Study. JMIR Perioper Med 2022;5:e40831. doi:10.2196/40831.
9 Chen C-S, Huang T-S, Lee SS-J, Chien F-C, Yan C-H, Li S-S, et al. Using a Knowledge-Based Clinical Decision Support System to Reduce the Time to Appropriate Antimicrobial Therapy in Hospitalized Patients With Bloodstream Infections: A Single-Center Observational Study. Open Forum Infect Dis 2022;9:ofac522. doi:10.1093/ofid/ofac522.
10 Aninanya GA, Williams JE, Williams A, Otupiri E, Howard N. Effects of computerized decision support on maternal and neonatal health-worker performance in the context of combined implementation with performance-based incentivisation in Upper East Region, Ghana: a qualitative study of professional perspectives. BMC Health Serv Res 2022;22:1581. doi:10.1186/s12913-022-08940-0.
11 Santos MT, Rodrigues BM, Shizukuda S, Oliveira AF, Oliveira M, Alves Figueiredo DL, et al. Clinical decision support analysis of a microRNA-based thyroid molecular classifier: A real-world, prospective and multicentre validation study. EBioMedicine 2022;82:104137. doi:10.1016/j.ebiom.2022.104137.
12 Lobach DF, Boxwala A, Kashyap N, Heaney-Huls K, Chiao AB, Rafter T, et al. Integrating a Patient Engagement App into an Electronic Health Record-Enabled Workflow Using Interoperability Standards. Appl Clin Inform 2022;13:1163–71. doi:10.1055/s-0042-1758736.
13 McCoy AB, Russo EM, Johnson KB, Addison B, Patel N, Wanderer JP, et al. Clinician collaboration to improve clinical decision support: the Clickbusters initiative. J Am Med Inform Assoc 2022;29:1050–9. doi:10.1093/jamia/ocac027.
14 Nguyen JQ, Crews KR, Moore BT, Kornegay NM, Baker DK, Hasan M, et al. Clinician adherence to pharmacogenomics prescribing recommendations in clinical decision support alerts. J Am Med Inform Assoc 2022;30:132–8. doi:10.1093/jamia/ocac187.
15 Murad DA, Tsugawa Y, Elashoff DA, Baldwin KM, Bell DS. Distinct components of alert fatigue in physicians' responses to a noninterruptive clinical decision support alert. J Am Med Inform Assoc 2023;30:64–72. doi:10.1093/jamia/ocac191.
16 Chong AZ, Lee B, Hollenbach K, Kuelbs CL. Disappearing Help Text: Implementing a Note-Based Tool for In-Line Clinical Decision Support and Note Bloat Reduction. Appl Clin Inform 2022;13:1033–9. doi:10.1055/a-1934-8323.