Related Experiment Video
Updated: Mar 25, 2026
Development of a Benchtop Model for Evaluating the Compatibility of Wound Dressing Materials with Negative Pressure Wound Therapy Systems
Published on: May 2, 2025
Utility of a Smartphone-Based Clinical Decision Support System for Pressure Ulcer Management by Physicians:
Takahiro Ito1,2, Takanobu Hirosawa1, Arisa Hayashi1
1Department of Diagnostic and Generalist Medicine, Dokkyo Medical University, Tochigi, Japan.
Background:
Clinical decision support systems (CDSSs) are widely used in various health care settings. In Japan, pressure ulcers are becoming a major concern in an aging society due to their increasing prevalence. However, management is often handled by nonspecialists in wound care due to regional disparities in specialist availability.
Objective:
To provide support for nonspecialists in wound care, we developed a prototype smartphone-based CDSS for pressure ulcer management. The system prompts users to answer questions about the wound's condition and recommends appropriate ointments and wound dressings by using a safety-first approach. This study aims to evaluate the utility of this system.
Methods:
We conducted a randomized crossover pilot study involving 28 general internal medicine (GIM) physicians. Participants were randomly assigned to group A (intervention-control) or group B (control-intervention). Participants evaluated 10 standardized pressure ulcer photographs and selected the most appropriate ointment and wound dressing for each. The unit of analysis was the individual response to each question (N=280 total observations). We used generalized estimating equations with an exchangeable correlation structure to account for within-subject clustering and adjust for potential period and sequence effects.
Results:
The overall correct response rate during the intervention phase was significantly higher than that during the control phase (49.3% vs 4.3%, respectively). After adjusting for clustering and crossover biases, the use of CDSS was associated with a 29.1-fold increase in the odds of a correct response (95% CI 8.2-103; P<.001). Secondary analyses revealed significant improvements in ointment selection (adjusted odds ratio [aOR] 2.4, 95% CI 1.5-3.8; P<.001) and wound dressing selection (aOR 8.9, 95% CI 4.9-16.1; P<.001). However, no significant period (P=.11) or sequence (P=.25) effects were observed for the primary outcome.
Conclusions:
The prototype CDSS improved the accuracy of treatment decisions made by GIM physicians in a pilot study that used photographs and fixed options. Within the parameters of this investigation, CDSS effectively guided participants toward standardized, safety-oriented choices as defined by our scoring criteria.
Trial Registration:
UMIN Clinical Trials Registry UMIN000057294; https://tinyurl.com/36a6vvah.
Related Concept Videos
01:27Nursing Clinical Information System
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include:
01:25Peptic Ulcer Disease V: Surgical Management and Nursing Care
Surgical Interventions for Peptic Ulcer Disease
01:30Health Information Technology and Healthcare Information System
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
01:26Peptic Ulcer Disease IV: Management
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
01:26Peripheral Artery Disease IV: Nursing Management
01:20Integrated Healthcare System