Development of a Clinical Decision Support Chatbot to Improve Access to Dental Clinical Practice Guidelines for...

Managing patients receiving warfarin therapy who require tooth extraction presents a significant clinical challenge due to the dual risks of postoperative bleeding and thromboembolic complications. Limited accessibility to clinical practice guidelines. This research aimed to develop and evaluate a clinical decision support (CDS) chatbot to enhance accessibility and usability of dental CPGs for warfarin-treated patients. Using a Research and Development (R&D) approach based on the ADDIE model ( Analysis, Design, Development, Implementation, Evaluation) was employed. The study involved 15 purposively selected dental personnel and was conducted from October 2025 to January 2026. The system was developed as a rule based CDS chatbot integrated with the LINE Messaging API. System performance, usability, and clinical outcome were evaluated using quantitative and qualitative methods.Results showed that the chatbot achieved high technical stability, passing 95% of functionality tests. Experts rated data accuracy at the highest level (x-=4.63). Post-implementation outcomes demonstrated a statistically significant improvement (p<0.001): the average data access time was reduced from 12.80 to 2.30 minutes, user satisfaction increased from 2.85 to 4.32, and reported bleeding incidents dropped significantly. In conclusion,The CDS chatbot effectively improves access to clinical guidelines and supports safer, more efficient decision-making in dental care for patients receiving warfarin. The system demonstrates strong potential for integration into routine clinical workflows and future expansion to other clinical domains.