BACKGROUND Guidelines exist for chronic kidney disease (CKD) but are not well implemented in clinical practice. We evaluated the impact of a guideline-based clinical decision support system (CDSS) on laboratory monitoring and achievement of laboratory targets in stage 3-4 CKD patients. METHODS We performed a matched cohort study of 12,353 stage 3-4 CKD patients whose physicians opted to recei...

PURPOSE Computerized clinical decision support systems (CDSSs) for intensive insulin therapy (IIT) are increasingly common. However, recent studies question IIT's safety and mortality benefit. Researchers have identified factors influencing IIT performance, but little is known about how workflow affects computer-based IIT. We used ethnographic methods to evaluate IIT CDSS with respect to other ...

AIM To design and evaluate a clinical decision support system (CDSS) to support cardiovascular risk prevention in type 2 diabetes. METHODS A preliminary requirements specification and three prototype CDSS interface designs were developed. Seven patients and seven clinicians conducted 'usability tests' on five different task scenarios with the CDSS prototypes to test its effectiveness, efficie...

The use of electronic health records has skyrocketed following the 2009 HITECH Act, which provides financial incentives to health care providers for the "meaningful use" of electronic medical record systems. An important component of the "Meaningful Use" legislation is the integration of Clinical Decision Support Systems (CDSS) into the computerized record, providing up-to-date medical knowledg...

The success of Clinical Decision Support Systems (CDSS) greatly depends on its capability of being integrated in Health Information Systems (HIS). Several proposals have been published up to date to permit CDSS gathering patient data from HIS. Some base the CDSS data input on the HL7 reference model, however, they are tailored to specific CDSS or clinical guidelines technologies, or do not focu...

Telehealth holds the promise of improved consistency and fast and equal access to care, and will have great impact on future care. To enhance its quality and safety, computerized decision support systems (CDSS) have been launched. This commentary focuses specifically on the impact of telehealth and CDSS on diabetes patient management. Ideally, clinical information should be linked to evidence b...

OBJECTIVES The purpose of this study was to develop clinical decision support systems (CDSS) that are integrated with hospital information systems for the differential diagnosis of idiopathic pulmonary fibrosis (IPF). METHODS The integrated CDSS were validated and evaluated by physicians. Knowledge modeling for diagnosing IPF was performed by knowledge working groups, composed of radiologists...

In order to increase compliance with The Joint Commission's Congestive Heart Failure Core Measures, a rule based clinical decision support system (CDSS) was developed and deployed at a community hospital in our health system. We evaluated the performance of the CDSS in identifying patients with primary congestive heart failure (CHF)and identified problems encountered with its introduction. Perf...

There is a pressing need for reliable and valid rating scales to assess and measure depression in individuals at ultra-high risk (UHR) of psychosis. The aim of this study was to examine the clinical utility of the Calgary Depression Scale for Schizophrenia (CDSS) in individuals at UHR of psychosis. 167 individuals at UHR of psychosis were included as participants in this study. The Structured C...

OBJECTIVE To evaluate the accuracy of a computerized clinical decision-support system (CDSS) designed to support assessment and management of pediatric asthma in a subspecialty clinic. DESIGN Cohort study of all asthma visits to pediatric pulmonology from January to December, 2009. MEASUREMENTS CDSS and physician assessments of asthma severity, control, and treatment step. RESULTS Both th...