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An overview of clinical decision support systems: benefits, risks, and strategies for success.
npj Digital Medicine ( IF 12.4 ) Pub Date : 2020-02-06 , DOI: 10.1038/s41746-020-0221-y
Reed T Sutton 1 , David Pincock 2 , Daniel C Baumgart 1 , Daniel C Sadowski 1 , Richard N Fedorak 1 , Karen I Kroeker 1
Affiliation  

Computerized clinical decision support systems, or CDSS, represent a paradigm shift in healthcare today. CDSS are used to augment clinicians in their complex decision-making processes. Since their first use in the 1980s, CDSS have seen a rapid evolution. They are now commonly administered through electronic medical records and other computerized clinical workflows, which has been facilitated by increasing global adoption of electronic medical records with advanced capabilities. Despite these advances, there remain unknowns regarding the effect CDSS have on the providers who use them, patient outcomes, and costs. There have been numerous published examples in the past decade(s) of CDSS success stories, but notable setbacks have also shown us that CDSS are not without risks. In this paper, we provide a state-of-the-art overview on the use of clinical decision support systems in medicine, including the different types, current use cases with proven efficacy, common pitfalls, and potential harms. We conclude with evidence-based recommendations for minimizing risk in CDSS design, implementation, evaluation, and maintenance.

中文翻译:

临床决策支持系统概述:收益、风险和成功策略。

计算机化临床决策支持系统(CDSS)代表了当今医疗保健领域的范式转变。CDSS 用于增强临床医生复杂的决策过程。自 20 世纪 80 年代首次使用以来,CDSS 经历了快速发展。它们现在通常通过电子病历和其他计算机化临床工作流程进行管理,这得益于全球越来越多地采用具有先进功能的电子病历。尽管取得了这些进展,但 CDSS 对使用它们的提供者、患者结果和成本的影响仍然未知。在过去的十年中,已经发表了许多 CDSS 成功案例,但显着的挫折也向我们表明 CDSS 并非没有风险。在本文中,我们提供了有关临床决策支持系统在医学中的使用的最新概述,包括不同类型、已证明有效的当前用例、常见陷阱和潜在危害。最后,我们提出了基于证据的建议,以尽量减少 CDSS 设计、实施、评估和维护中的风险。
更新日期:2020-02-06
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