Utility of a Smartphone-Based Clinical Decision Support System for Pressure Ulcer Management by Physicians:...

Area of Science:

• Medical Informatics
• Wound Care Management
• Clinical Decision Support Systems

Background:

• Pressure ulcers are a growing concern in aging populations, particularly in Japan.
• Management is often performed by non-specialists due to limited access to wound care experts.
• Disparities in specialist availability necessitate accessible support tools.

Purpose of the Study:

• To evaluate the utility of a prototype smartphone-based clinical decision support system (CDSS) for pressure ulcer management.
• To support non-specialists in making appropriate treatment decisions for pressure ulcers.
• To assess the system's ability to recommend ointments and dressings using a safety-first approach.

Main Methods:

• A randomized crossover pilot study involving 28 general internal medicine physicians.
• Participants evaluated standardized pressure ulcer photographs and selected treatments.
• Generalized estimating equations were used to analyze data, accounting for within-subject clustering and crossover effects.

Main Results:

• The CDSS intervention significantly increased the correct response rate from 4.3% to 49.3% (29.1-fold increase in odds).
• Significant improvements were observed in both ointment selection (aOR 2.4) and wound dressing selection (aOR 8.9).
• No significant period or sequence effects were found for the primary outcome.

Conclusions:

• The prototype CDSS effectively enhanced the accuracy of treatment decisions for pressure ulcers made by general internal medicine physicians.
• The system guided users toward standardized, safety-oriented choices in a pilot study setting.
• Smartphone-based CDSS shows promise for improving wound care management by non-specialists.