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A taxonomic description of computer-based clinical decision support systems
Amy Berlin1, Marco Sorani, Ida Sim
1Department of Psychiatry, University of California, San Francisco, CA, USA.
Journal of Biomedical Informatics
|January 31, 2006
Summary
Computer-based clinical decision support systems (CDSSs) are diverse. Findings show significant variation in CDSS design and impact, cautioning against generalizing trial results across different settings.
Area of Science:
- Health Informatics
- Clinical Decision Support Systems
Background:
- Computer-based clinical decision support systems (CDSSs) exhibit considerable variability in their design and functionality.
- A previously developed taxonomy was utilized to characterize these systems.
Purpose of the Study:
- To describe the characteristics of CDSSs reported in scientific literature.
- To analyze the heterogeneity of CDSSs based on a defined taxonomy.
Main Methods:
- Systematic literature search of PubMed and Cochrane Library for randomized controlled trials (RCTs) from 1998-2003.
- Coding of 74 CDSSs from 58 studies using a pre-established taxonomy.
Main Results:
- Significant variation observed in CDSS context, knowledge/data sources, support type, information delivery, and workflow impact.
- Identified two main subsets: patient-directed (38%) and inpatient clinician-targeted (18%).
- 84% of CDSSs required additional staffing for input/output management.
Conclusions:
- Reported CDSSs are highly heterogeneous across multiple dimensions.
- Results from CDSS RCTs should be interpreted with caution when generalizing to different clinical or workflow environments.
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