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Usage Patterns of Web-Based Stroke Calculators in Clinical Decision Support: Retrospective Analysis
Benjamin Kummer1,2, Lubaina Shakir3, Rachel Kwon4
1Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
JMIR Medical Informatics
|August 2, 2021
Summary
The CHA₂DS₂-VASc, Mean Arterial Pressure, HAS-BLED, NIHSS, and CHADS₂ calculators are most frequently used for stroke decisions. Most users accessed these tools via web browser, primarily from populated, English-speaking regions.
Area of Science:
- Neurology
- Medical Informatics
- Health Services Research
Background:
- Clinical scores are vital for stroke diagnosis and management.
- Medical calculators are essential decision support tools, but their use in stroke care is not well understood.
Purpose of the Study:
- To characterize the usage patterns of frequently utilized stroke-related medical calculators.
- To analyze data from a web-based medical calculator platform to understand calculator adoption.
Main Methods:
- Retrospective analysis of calculator usage data from MDCalc (2016-2018).
- Identified stroke-related calculators and analyzed relative page views to determine the top 5.
- Examined access modes, geographic distribution (US and international), and usage trends over time.
Main Results:
- 48 of 454 calculators were stroke-related; top 5: CHA₂DS₂-VASc, Mean Arterial Pressure, HAS-BLED, NIHSS, CHADS₂.
- Web browser access dominated (82.7%-91.2%); usage concentrated in populated US regions and English-speaking countries.
- National Institutes of Health Stroke Scale (NIHSS) calculator showed the largest page view increase (238.1%).
Conclusions:
- CHA₂DS₂-VASc, Mean Arterial Pressure, HAS-BLED, NIHSS, and CHADS₂ are the leading stroke calculators.
- Usage is predominantly via web browser, from English-speaking countries, and highly populated areas.
- Further research is needed on barriers to adoption and the impact of calculator use on stroke care best practices.
Keywords:
cerebrovascular diseaseclinical healthclinical informaticsdigital healtheconomic healthelectronic health recordshealth informationhealth information technologyinformation technologymedical calculatorsmedical informaticsmhealth
