Clinical decision support system

A clinical decision support system (CDSS) is a health information technology system that is designed to provide physicians and other health professionals with clinical decision support (CDS), that is, assistance with clinical decision-making tasks. A working definition has been proposed by Robert Hayward of the Centre for Health Evidence: "Clinical decision support systems link health observations with health knowledge to influence health choices by clinicians for improved health care". CDSSs constitute a major topic in artificial intelligence in medicine.

The evidence of the effectiveness of CDSS is mixed. A 2014 systematic review did not find a benefit in terms of risk of death when the CDSS was combined with the electronic health record. There may be some benefits, however, in terms of other outcomes.

A 2005 systematic review concluded that CDSSs improved practitioner performance in 64% of the studies. The CDSSs improved patient outcomes in 13% of the studies. Sustainable CDSSs features associated with improved practitioner performance include the following:

Both the number and the methodological quality of studies of CDSSs increased from 1973 through 2004.

Another 2005 systematic review found... "Decision support systems significantly improved clinical practice in 68% of trials." The CDSS features associated with success include the following:

However, other systematic reviews are less optimistic about the effects of CDS, with one from 2011 stating "There is a large gap between the postulated and empirically demonstrated benefits of [CDSS and other] eHealth technologies ... their cost-effectiveness has yet to be demonstrated".

A 5-year evaluation of the effectiveness of a CDSS in implementing rational treatment of bacterial infections was published in 2014; according to the authors, it was the first long term study of a CDSS.

A clinical decision support system has been defined as an "active knowledge systems, which use two or more items of patient data to generate case-specific advice." This implies that a CDSS is simply a decision support system that is focused on using knowledge management in such a way so as to achieve clinical advice for patient care based on multiple items of patient data.

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