A web-based intensive care clinical decision support system: from design to evaluation.

Area of Science:

• Medical Informatics
• Clinical Decision Support Systems
• Intensive Care Medicine

Background:

• Effective decision-making in intensive care units (ICUs) is critical for patient outcomes.
• Existing clinical guidelines and protocols can be complex to access and apply in real-time.
• There is a need for tools to support ICU providers in making timely and accurate clinical decisions.

Purpose of the Study:

• To develop and evaluate a web-based clinical decision support system (CDSS) for ICU providers.
• To assess the impact of the CDSS on decision-making effectiveness and efficiency.
• To determine the usability of the developed system.

Main Methods:

• A survey of 38 physicians identified needs and preferences for decision support tools.
• Clinical guidelines were converted into algorithms by specialists and a medical informatician.
• Ten CDSS were developed and integrated into the Intensive Care Decision Support Website (ICDSW).
• A comparative study involving 15 physicians evaluated ICDSW against a paper-based approach using 10 scenarios.
• Usability was assessed using a standardized score.

Main Results:

• Physicians using the ICDSW demonstrated significantly improved answer accuracy compared to the paper-based method (p < 0.001).
• There was no significant difference in the time required to answer questions between the two methods (p = 0.138).
• The ICDSW achieved a high usability score of 85.6 ± 8.89.

Conclusions:

• The developed Intensive Care Decision Support Website (ICDSW) is a successful tool for enhancing clinical decision-making in ICUs.
• The system improves the accuracy of decisions made by ICU providers.
• The ICDSW offers good usability and can be effectively implemented in intensive care settings.