Clinical Decision Support System Used in Spinal Disorders: Scoping Review

Area of Science:

• Medical Informatics
• Spine Surgery
• Healthcare Technology

Background:

• Spinal disorders represent a significant global health burden with substantial socioeconomic costs.
• Clinical decision support systems (CDSSs) are increasingly utilized to enhance healthcare efficiency and safety across various specialties.
• The growing prevalence of spinal conditions necessitates innovative technological solutions for improved patient outcomes.

Purpose of the Study:

• To conduct a scoping review exploring the application of CDSSs in the management of spinal disorders.
• To identify and categorize the primary functions of CDSSs used in spinal disorder care.

Main Methods:

• Adherence to Joanna Briggs Institute methodology and PRISMA-ScR guidelines for scoping reviews.
• Comprehensive literature search across major databases (PubMed, Embase, Scopus, etc.) until October 2022.
• Inclusion of studies focusing on digitalized CDSSs for patients with spinal disorders.

Main Results:

• Four key CDSS functions identified: preventing unnecessary imaging (26%), aiding diagnosis (19%), aiding prognosis (35%), and recommending treatment (20%).
• Knowledge-based systems were predominantly used, with logistic regression and decision tree algorithms being common analytical methods.
• Physicians generally accepted CDSS use, outweighing concerns about clinical decision-making autonomy.

Conclusions:

• Current effectiveness evaluations often rely on agreement with healthcare providers; comparison with actual clinical outcomes is recommended.
• Future CDSS development should prioritize system integration, end-user needs, and external validation for assessing effectiveness and generalizability.
• Further research is needed to validate CDSS impact on real-world clinical practice and patient outcomes in spinal disorders.